WGU C787 Nutrition Review Questions and Answers plus well summarized Notes

When nutrition advocates became concerned that recommendations did not do enough to address prevention of chronic diet related diseases, what policy change were made? Correct answer- RDA's (Recommended Daily Allowances) expanded into several DRI (Daily Reference Intakes) What is true of dietary reference intake? choose two. Correct answer- Food labeling must include information about them. They differ depending on age and gender What is always found on a nutrition label in the US? Correct answer- Serving size A healthful diet contains nutrient intake near what amount? Correct answer- RDA (Recommended daily allowance) -The average daily intake level estimated to meet the needs of nearly all people in a certain group. Aim for this amount! -Use this for planning family meals sufficient for infants, children, adults and ELDERLY family members. What is an appropriate use of AMDR (Acceptable Macronutrient Dietary Range) when evaluating the appropriateness of a snack food? Correct answer- 50% calories from fat is too much. (There is an AMDR for fats, carbs, and proteins only. It is a range of percentages of calories that you should get from that nutrient per day.) The AMDR for fats is 20-35%** AMDR for protein Correct answer- 10-35% AMDR for fat Correct answer- 20-35% AMDR for carbs Correct answer- 45-65% What is meant by Tolerable Upper Intake Level? Correct answer- The highest level of daily consumption that current data has shown to cause no side effects in humans; ensures people do not take harmful amounts. (More for supplements; No side effects in humans) How is estimated average requirement (EAR) commonly used? Correct answer- To guide recommendations and menu planning for COMMUNITIES in combinations with upper intake levels. What is true of recommendations as presented by their setting place graphic? Correct answer- Half of the plate should be fruits and vegetables. What is the nutritional benefit of fruits and vegetables? Correct answer- They provide phytonutrients (nutrients from plants) that reduce the risk some types of cancer. (They are high in fiber/bulk, vitamins and minerals, low in calories.) What is FALSE regarding fruits and vegetables in the diet? Correct answer- Fruits and vegetables are rich in vitamin B12 (Watch for the negative/false/incorrect questions!!) Number of recommended servings of fruits and vegetables per day Correct answer- 9 Increasing the amount of colorful vegetables reduces the risk of: Correct answer- Stroke What strategy might be AVOIDED due to expense for patients looking to eat more healthfully on a budget? Correct answer- Buying frozen meals Strategies for balanced healthy meal planning on a budget Correct answer- -buying canned veggies in bulk -buying only the amount of fresh veggies that can be eaten at the time (to avoid wasting them) -buying veggies whole and preparing/trimming them at home (precut veggies are more expensive) -grow veggies and herbs at home -buy only in season veggies Which statement is true about planning a balanced meal? Correct answer- Skim milk has roughly the same amount of calcium and protein as whole milk. (Always stick with reduced or no fat dairy products) What is true about dietary recommendations for whole grain intake? Correct answer- Half of all whole grains consumed should be whole grain products. Fritz is hosting a brunch and prepares for each of his friends: Omelet with cheese Toasted English muffin 1t all fruit preserves ½ large grapefruit 1c whole milk How can his menu be improved to follow the dietary guidelines for Americans? Choose all that apply Correct answer- Use egg whites for the omelets Replace cheese with vegetables in the omelets Replace English muffin with whole wheat English muffin Replace whole milk with fat free milk (Adding juice will never be an answer because it is sugar water.) What is true of recommendations concerning trans fat and added sugar intake? Correct answer- Trans fat and added sugar intake should be minimized. There is no DRI value! What is recommended daily amount of protein intake? Correct answer- 60g/ day or 0.8gm/kg Which list contains all examples of protein? Correct answer- Garbanzo beans (Chickpeas) Egg Chicken breast Yogurt Cheese Ground beef Peanut butter Tofu What is the best choice for a combination of plant-based foods to maximize healthy diet in a vegetarian diet? Correct answer- Legume + whole grain There is a current initiative for more transparent labeling of sugars on nutrition fact labels. In the coming years, which of these might be more obviously labeled sugars? Choose all that apply. Correct answer- -Anything ending in-ose -Honey (Most things ending in ose are sugars like glucose, fructose, etc. **Not -ase which are enzymes) Which carbohydrate will cause a quick return to hunger? Correct answer- One with a higher glycemic index (Measures how the body responds to a sugar, high index is a high fast blood sugar and insulin spike and low index would mean it raises blood sugar slower.) Which is the reason that seafood can be considered a healthful diet? Correct answer- Some seafood is high in heart healthy omega 3 oils What are generally considered sources of healthy fat? Correct answer- Fish, nuts, olive oil What is NOT a common source of high levels of sodium? Correct answer- Spices and herbs (Manufactured breads, processed food and canned soup/broth tend to have lots of sodium) Which foods are relatively rich in iron? Choose all that apply Correct answer- Dark leafy greens, legumes, red meat, nuts What is the best vegetarian source of iron from the options provided? Correct answer- Beans (Legume!) Which of these are protective against heart disease? Correct answer- Fiber, HDL cholesterol (good cholesterol) Which are linked to increase heart disease risk? Correct answer- LDL (bad cholesterol), trans fat, saturated fats Reducing heart disease/ stroke Correct answer- LDL levels below 120mg/dl Limit cholesterol intake to less than 30mg per day Saturated fats-less than 7% of total daily calories At least 30 minutes of activity in daily routine Sodium levels-below 1600mg per day Increase intake of fiber, especially INSOLUBLE fiber, although ***most will be soluble. Limit alcohol to 1-2 drinks per day. What is an appropriate dietary intervention to address a patient's low albumin level? Correct answer- High protein diet Select foods that would be inappropriate for a patient with kidney disease? Correct answer- Fried eggs, hot dogs, steak (**Watch proteins because they are broken down into ketones which are difficult for the kidneys) What is the DASH diet designed to address? Correct answer- Hypertension (Dietary Approaches to Stop Hypertension) Which factors are important in controlling hypertension? Select all that apply Correct answer- Sodium below 1600mg daily Daily exercise such as a half hour walk Maintaining a healthy weight-BMI below 25 Another benefit of fiber Correct answer- It lowers the absorption rate of glucose in the body Because obesity affects many organ systems and hormones impairing body functions, which is true? Correct answer- It is now considered a disease by the AMA Kwashiorkor Correct answer- A form of malnutrition caused by inadequate protein intake Seen in regions experiencing famine Kwashiorkor S/S Correct answer- Muscle wasting, decreased ability to maintain fluid balance, edema of limbs and face, inflammation due to liver being unable to clear toxins and infections. Hair loses its color, skin is patchy, sores don't heal. Marasmus Correct answer- Marasmus literally means "to waste away" and is an acute form of malnutrition. It is caused by a deficiency of both calories and protein in the diet. This is the most severe form of childhood malnutrition. Marasmus S/S Correct answer- Muscle wasting, impairment of brain development, decreased learning ability, decreased temp, little to no subcutaneous fat, engage in little to no activity to allow all energy to be used for essential body functions Pellagra is a _____ deficiency disease. Correct answer- Niacin Pellagra S/S Correct answer- diarrhea, dermatitis, dementia, death What BMI is considered OBESE, requiring counseling about a weight loss dietary plan? Correct answer- BMI 30 Vitamin A deficiency Correct answer- night blindness, dry skin Vitamin C deficiency Correct answer- scurvy, hemorrhagic diathesis, poor wound healing Iodine deficiency symptoms Correct answer- - Goiter (enlargement of the thyroid gland), leads to hypothyroidism which leads to weight gain and slow BMR - cretinism: severe mental and physical retardation Overweight BMI Correct answer- BMI 25 Morbidly obese BMI Correct answer- BMI 40 Low BMI Correct answer- BMI 18.5 How to calculate BMI Correct answer- 1. Take patients height in inches and square it (ex: 5'4" = 64 in; 64 ^2 = 4096) 2. Divide the weight in pounds by the number you get (ex: 175/4096 = 0.043) 3. Multiply the answer to step two by 703 (ex: 0.043 x 703 = 30) What is the BMI calculation for a patient that measures 5'4" in height and 175 lbs in weight? Correct answer- 30 What describes a diet LEAST likely to result in obesity? Correct answer- A diet with a variety of fruits, whole grains and vegetables. Identify which heart disease risk factors are modifiable Correct answer- Sedentary lifestyle BMI 32kg/m2 Diet high in trans fat Which statement is true? Correct answer- Obese children and teenagers are at increased risk of coronary heart disease You are working in a family medicine clinic with a 22 yr old patient. You note a BMI of 17. What counseling might you give this patient? Correct answer- "At this BMI you are at an increased risk of infertility, osteoporosis and premature death. Let's find solutions." What health risks clearly increase along with BMI? Select all that apply. Correct answer- Heart Disease Type 2 diabetes, Premature death Osteoarthritis Sleep apnea What is true regarding genetic influence on body weight? Correct answer- Body weights of parents are often predictive of children even when they do not raise them. To maintain weight in the long term, patients should: Correct answer- Balance energy expenditure with energy intake; eat just enough calories for activity level. What are the physical activity guidelines for Americans for different age groups and what benefits are seen with these levels of physical activity? Correct answer- Aerobic: Most of the 60 minutes or more per day should be either moderate or vigorous intensity aerobic activity and should include vigorous intensity activity at least 3 days per week. HEI (healthy eating index) Correct answer- A measure of diet quality used to assess how well a set of foods aligns with key recommendations of the Dietary Guidelines for Americans What foods/products are regulated by the FDA? Correct answer- Drugs, dietary supplements, ensures that foods people eat in the US are safe, wholesome, sanitary, and properly labeled. Regulates meats from exotic animals Meanwhile, they are responsible for regulating - and slapping a nutrition facts label - on all processed foods created and sold in the US. What foods/products are regulated by the USDA? Correct answer- Mainly meat, poultry, and eggs - also food that crosses state boundaries or involves more than one state. But under it's umbrella also falls the Center for Nutrition Policy and Promotion, which established dietary guidelines and the food and nutrition service which administers SNAP benefits. You can only draft five pieces of advice for weight loss. Which do you choose? Correct answer- -Reduce processed foods -Increase activity -When you want food, ask yourself, "am I hungry?" -Eat 5 small meals to maintain energy throughout the day, -Limit sugary drinks. (Pick the top 5, more may be good, but pick the Best) Which person is most likely to lose weight and keep it off? Correct answer- One who sticks to their diet long term. Which is true about weight loss? Correct answer- 10% reduction in total weight has consistently been shown to improve health and decrease risk. Ex: A 180 lb person would need to lose 18 lbs (down to 162 lbs), a 265 lb person would need to lose 26.5 lbs (down to 238.5 lbs), a 430 lb person would need to lose 43 lbs (down to 397) Which is likely NOT an appropriate, sustainable weight goal? Correct answer- To lose 20 pounds in a month and be envied by friends Examples of appropriate, sustainable weight loss goals Correct answer- -to reduce risk of chronic disease -to increase energy level -to be able to be more physically active with less joint pain What is true of water intake and weight loss? Correct answer- There is evidence to support that drinking 48oz of water or more supports weight loss. Which foods are likely appropriate for consistent inclusion on a weight reduction dietary plan? Choose all that apply. Correct answer- Baked fish Seasoned green vegetables Skinless chicken breast Which are thought to be societal factors in the obesity epidemic? Choose all that apply. Correct answer- -More desk based, low activity jobs. -Increasing size of food portions at restaurants and at home. -Increased consumption of processed foods. Obesity messages to adolescents: Correct answer- -Focus on a healthy diet, not weight loss diets. -Reinforce healthy behavior -Don't reward with food -Watch consumption of media messages determine content, credibility, etc. What is INAPPROPRIATE advice to a family of a 14-year-old with anorexia? Correct answer- Serve separate meals to different family members. (Everyone should eat a well-balanced meal together) What is true of physical activity, in conjunction with diet, to support weight loss? Correct answer- Patients should strive for 90 minutes of moderate physical activity at least 3 times a week. What is a legal supplement body builder take in an effort to increase muscle mass and increase nitrogen retention? Correct answer- Protein powder (an Ergogenic aid) What does the term anthropometrics refer to? Correct answer- Weight management assessment tools including weight, height, and waist size (Anthro=human, metrics=measurements) How do you calculate physical activity level (PAL)? Correct answer- Total Energy Expenditure/Body Mass Rate (Basal Metabolic Rate = Basal Energy Expenditure) You are in the family medicine clinic and are working with a patient with a BMI of 52 and a sedentary lifestyle. He is wondering about bariatric surgery. Which pieces of advice are appropriate? Choose all that apply. Correct answer- "Increase your physical activity now, but do it gradually, to reduce strain on your heart and increase your likelihood of keeping with it." "Even after surgery, you will need to continue to exercise." "After surgery, you may lose weight rapidly." "You will need to take specific vitamin supplements after surgery." What is true of nutrition for infants? Correct answer- Human milk contains immune factors that infant formula does not. Human milk does NOT need supplementation of vitamins and minerals, neither does infant formula There are not adequate intake levels for macronutrients for infants of all ages Why is juice not recommended for infants? Choose all that apply. Correct answer- - Contributes to dental decay (high in sugar) -Lacks fiber and may contribute to diarrhea -It is a high calorie source of fluid Which behavior may contribute to dental carries (cavities) in infants? Correct answer- Sharing utensils (bacteria) What parent behavior may put a child at risk of developing POOR relationship with food? Choose all that apply. Correct answer- Never involve children in meal planning Avoiding offering children choices How does the CDC define overweight in children? Correct answer- BMI for age over 85th percentile When teaching kindergartners (5-6yrs old) about Choose My Plate, what would an appropriate educational strategy be? Correct answer- Teach them a rhyme with the concepts When teaching 8-10 year olds about healthy meal planning, what would an appropriate educational strategy be? Correct answer- Have them write out a description of a healthy menu with different food groups You are working in a pediatrics practice and have an appointment with an obese 9-year- old boy and his parents. What are some pieces of advice you might give the family? Correct answer- -High levels of stress can cause poor eating habits -Limit portion sizes and avoid frequent restaurant meals -Encourage the child to help choose and prepare meals -Encourage physical active play and not just desk-based study -Provide and model choices of healthy plant-based snacks and colorful fruits and vegetables at meals What are some strategies to AVOID when teaching high school students about nutrition? Choose all that apply. Correct answer- -Focus on how good nutrition will make them pretty -Explain ways to skip or replace meals. A healthy 17-year-old girl is reading a nutrition label and sees that a product contains 13% DV of calcium per serving. How many servings of this product would this girl need to have that day to get the recommended amount of calcium from that product alone? Correct answer- 10 servings (10x13=130) (Recommended DV of 130% for adolescents instead of 100% like adults.) A nurse is evaluating a 16-year-old boy with short stature (stunted linear growth), poor bone development, and cognitive development delays. What might be a dietary cause of this boy's condition? Correct answer- Malnutrition. What nutrient do young adolescent have an increased need for relative to adults? Correct answer- Thiamine What is appropriate advice to give a newly pregnant mother? Correct answer- Alcohol should be avoided during all trimesters of pregnancy What is a possible effect of alcohol consumption during pregnancy on the fetus? Correct answer- Permanent developmental disability (fetal alcohol syndrome) What nutrient reduces the risk of neural tube defects? Correct answer- Folate/Folic acid What are some good dietary sources of folate? Correct answer- Lentils, spinach, oats How can a pregnant mother minimize the risk of preterm delivery? Select all that apply. Correct answer- Abstain from tobacco and drugs prior to conception and through pregnancy Discontinue use of alcohol Maintain a healthy weight Maintain healthy diet to prevent gestational diabetes What is FALSE about breastfeeding? Correct answer- It is a reliable form of birth control Breastfeeding Correct answer- -burns extra calories and can promote a quicker return to pre-pregnancy weight -requires extra fluid consumption -promotes oxytocin release -may reduce the risk of childhood obesity Why are adults over 70 years of age more vulnerable to inadequacy of one or more dietary nutrients? Correct answer- Different GI physiology interferes with absorption What are some potential benefits of prebiotics and probiotics for an older adult? Choose all that apply. Correct answer- -Decreased total cholesterol -Control of IBS - yogurt/cultured products -Support immune system function -Rebuild bone density How might you advise a patient about adapting to older adulthood? Correct answer- "To avoid obesity, remain active, and realize your overall caloric needs may decrease." A patient is considering adding a dietary supplement and wants to know more. What should they do first? Correct answer- Discuss it with their healthcare provider To which patient represented by a quote in a meeting with the nurse, should the nurse recommend a dietary supplement? Correct answer- "The doctor said my labs showed that I have iron-deficiency anemia. The phrase "Not intended to diagnose, treat, cure or prevent any disease": Correct answer- Is required to appear on the label of all supplements. Which vitamins can be flushed out in the urine stream if they are in moderate excess? Select all that apply. Correct answer- B vitamins Vitamin C (Water soluble vs fat soluble (K, A, D, E) Fat soluble vitamins Correct answer- K, A, D, E Match the supplement with what it aims to improve. Correct answer- Ergogenic aid- athletic performance Nootropic- enhances cognition Probiotic- digestive system Galactagogue- increased breastmilk production. Supplements may or may not contain an active ingredient. What else may they contain? Correct answer- Extra ingredients that are unlisted and are similar to fillers in Rx drugs How should you counsel a patient about providing information about the supplements they take to the healthcare team? Correct answer- "Supplements can interact with medicine and make the medicine's effect too strong. This can cause a life-threatening event." Match the nutrient to its deficiency: Correct answer- Thiamine- beriberi Iodine- brain damage, intellectual impairment, goiter Vitamin A- blindness Vitamin D- rickets Why do many women take calcium supplements? Correct answer- To reduce the risk of osteoporosis Vitamin k: Correct answer- -Fat soluble vitamin that aids in blood clotting -Should be avoided while on warfarin (Coumadin) What is unavailable in plant foods, and therefore may need to be consumed as a supplement to a vegetarian diet? Correct answer- Vitamin B12. What nutrients ARE available in plant foods but may require special consideration in a vegetarian diet? Select all that apply. Correct answer- Iron (dark, leafy greens and legumes) Vitamin D Protein (can be very difficult on a vegetarian diet) Calcium (must be a bioavailable form) A limited ability to acquire nutritionally adequate foods in socially acceptable ways is called? Correct answer- Food insecurity What is true of food waste and overpopulation? Correct answer- They are contributing factors to global hunger What are NATURAL causes of famine? Correct answer- Pests, draught, and flood *Famine affects agricultural output on a large scale What does the Economic Research Service do? Correct answer- Assists in providing research and analysis on food security issues in developing countries. Food deserts are often characterized by their lack of: Correct answer- Availability and accessibility of healthful foods (Food deserts are places w/ many people who are food insecure because of accessibility) What are characteristics of food deserts? Choose all that apply. Correct answer- -Fast foods are more affordable in the area -Markets in the area do not have fresh produce What are some public health strategies to reduce food deserts? Choose all that apply. Correct answer- -Implement urban farmer's market -Supporting public policy to reduce costs of fresh foods Financial limitations to adequate nutrition are a main focus of what diagnostic tool? Correct answer- Food Security Survey Module A situation where a person who consumes many calories, but without adequate nutrients, can be considered? Correct answer- Undernutrition, which also includes the chronically hungry What is an approptiate use of the Child Food Security Survey Module? Correct answer- Determine if a child is experiencing hunger at home. What does "Household Food Security Status" refer to? Correct answer- An outcome measure to examine the public's ability to secure adequate food. What is a term that means all people have access, at all times, to sufficient food for an active and a healthy life? Correct answer- Food security What is true of the Food Security Survey Module? Correct answer- It measures sufficiency of food and very low food security requires intervention. Low food security is characterized by? Correct answer- Reduced quality, variety, or desirability of diet What was one effect of the National Nutrition Monitoring and Related Research Act of 1990? Correct answer- Development of standardized questionnaires for measuring household food security status. The uneasy or painful sensation caused by the lack of food is known as.... Correct answer- Hunger Which factor might be a cause of a patient's frequent ED visits for congestive heart failure? Correct answer- The patient goes without medication because they cannot afford them until they are paid. What problems of factors can be associated with food insecurity? Choose all that apply. Correct answer- Poor nutrition Trouble obtaining food Obesity Lower cognitive and academic performance Poorer health status What does SNAP (Supplemental Nutrition Assistance Program) do? Correct answer- Help low income families who have trouble affording food acquire food. (Formerly known as food stamps) What is the most appropriate referral to have home meals delivered by Meals on Wheels? Correct answer- Male, age 82, limited income, mobility issues and cannot drive. Which is the most appropriate referral to the Women, Infants, and Children (WIC) program? Correct answer- Female, age 22, speaks limited English, 6 months pregnant, low income, difficulty obtaining prenatal care. What is NOT a primary consideration when addressing nutritional needs for a homeless patient? Correct answer- Is the food fair-trade certified? Things to consider when addressing the nutritional needs of a homeless person Correct answer- -is the food ready to eat or do they have to prepare it? -is the food non-perishable or will it require refrigeration? -is the food nutritionally adequate? What is a major barrier to nutritional education, and a strategy for overcoming that barrier? Correct answer- Illiteracy; screening for problems with written materials and providing verbal or picture-based instruction. When working with a patient who speaks limited English, what should be AVOIDED? Choose all that apply? Correct answer- Using text only to teach Using only traditional American food to teach. What program teaches older adults how to shop, plan, and prepare nutritious meals, as well as conducting hypertension assessments? Correct answer- Elderly Nutrition Program What is one way that programs seek to provide socialization to older adults? Correct answer- Providing meals in group settings Matching: Programs for those at risk. Correct answer- Senior farmer's market Nutrition Program: Allows older adults to acquire fruits and vegetables SNAP (Supplemental Nutrition Assistance Program): Helps low income families acquire food Special Supplementary Nutrition program- WIC: Recognizes medical and dietary risks to women and children Which is an important consideration of the Meals on Wheels program? Correct answer- That the meals are appealing to the patient's taste What is "food poisoning"? Correct answer- Can be caused by either primary infection by a microbe OR production of toxins by microbes. What is true of botulism? Correct answer- It is thought to be the most lethal bioterrorism agent. Which infections are most commonly disseminated by ingestion? (Fecal-oral) Choose all that apply. Correct answer- Cholera Shigellosis What is Food Systems Security? Correct answer- A system to focus on locating the source of bioterrorism incident and notifying affected facilities. What foods have been common sources of food contamination in recent years? Choose all that apply. Correct answer- Bean sprouts