Rd Exam Domain Ii - Nutrition Care Process And Model

Front 1

Signs/symptoms of Vit A deficiency

Back 1

Xerophthalmia (abn dryness of conjunctiva and cornea), night blindness, cessation of bone growth

Front 2

Signs/symptoms of Vit A toxicity

Back 2

Fatigue, muscle soreness, bone and joint pain, decreased clotting time

Front 3

S/S of Vit B1 (thiamin) deficiency

Back 3

Beriberi: loss of appetite, N/V, loss of feeling in hands and feet, muscle paralysis/loss of fxn in lower legs, and nystagmus (strange eye movements). Seen in alcoholics

Front 4

S/S of Vit B1 (thiamin) toxicity

Back 4

Rapid pulse, weakness

Front 5

S/S of Vit B2 (riboflavin) deficiency

Back 5

Cheilosis (fissures at corners of mouth), sore tongue, skin rash.

Front 6

S/S of B3 (niacin) deficiency

Back 6

Pellagra - the 4 D's: Diarrhea, Dermatitis, Dementia, Death

Front 7

S/S of B3 (niacin) toxicity

Back 7

Diarrhea, nausea, abnormal heart beat

Front 8

S/S of Pyridoxine (B6) deficiency

Back 8

Hypochromic, microcytic anemia

Front 9

S/S of Pyridoxine (B6) toxicity

Back 9

Depression, fatigue, neurological disorders

Front 10

S/S of folate/folic acid deficiency

Back 10

Macrocytic, megaloblastic anemia, birth defects

Front 11

S/S of folate/folic acid toxicity

Back 11

Diarrhea, can mask B12 deficiency

Front 12

S/S of cobalamin (B12) deficiency

Back 12

Pernicious/megaloblastic anemia (toxicity is rare)

Front 13

S/S of Vit C (ascorbic acid) deficiency

Back 13

Scurvy: impaired wound healing, hemorrhages, weakening of bones, connective tissue and teeth

Front 14

S/S of Vit C (ascorbic acid) toxicity

Back 14

Diarrhea, possible increased risk of kidney oxalate stones

Front 15

S/S of Vit D deficiency

Back 15

Rickets, osteomalacia

Front 16

S/S of Vit D toxicity

Back 16

Kidney stones, removal of calcium from bones

Front 17

S/S of Vit E deficiency

Back 17

Anemia, red cell breakage

Front 18

S/S of Vit E toxicity

Back 18

May interfere with anticoagulants

Front 19

S/S of Vit K deficiency

Back 19

Hemorrhage

Front 20

S/S of Vit K toxicity

Back 20

May interfere with anticoagulant drugs

Front 21

S/S of calcium deficiency

Back 21

Osteoporosis, tetany

Front 22

S/S of calcium toxicity

Back 22

Reduced renal function, kidney stones; elevated serum levels can lead to heart or respiratory failure

Front 23

S/S of chromium deficiency

Back 23

Abnormal glucose tolerance (toxicity rare)

Front 24

S/S of copper deficiency

Back 24

Anemia, skeletal disorders, Menkes Disease: genetic d/o characterized by retarded growth, impaired keratinization of hair ("kinky" or steel wool hair), deteriorating nervous system, etc.

Front 25

S/S of copper toxicity

Back 25

Wilson's disease: genetic d/o characterized by accumulation of copper in the tissues due to a defect in the ability to form ceruloplasmin, in addition the liver does not release copper into the bile as it should

Front 26

S/S of fluoride deficiency

Back 26

Increased risk for tooth decay

Front 27

S/S of fluoride toxicity

Back 27

Fluorosis: discoloration of teeth

Front 28

S/S of iodine deficiency

Back 28

mental retardation, goiter (enlargement of the thyroid gland)

Front 29

S/S of iodine toxicity

Back 29

May lead to hypothyroidism, goiter, or hyperthyroidism

Front 30

S/S of iron deficiency

Back 30

Anemia: microcytic, hypochromic

Front 31

S/S of iron toxicity

Back 31

Hemosiderosis: a storage d/o in through high intakes or genetic defect leading to excessive iron absorption without tissue damage.
Hemochromatosis: excessive iron absorption with tissue damage.

Front 32

S/S of magnesium deficiency

Back 32

Nausea, muscle tremors, confusion (toxicity rare)

Front 33

S/S of potassium deficiency

Back 33

Tachycardia, weakness, paralysis, may be fatal

Front 34

S/S of potassium toxicity

Back 34

Kidney failure, heart weakness, irregular heartbeat

Front 35

S/S of sodium toxicity

Back 35

Hypertension (deficiency rare)

Front 36

S/S of zinc deficiency

Back 36

Growth retardation, slow wound healing, reduced taste sensitivity,

Front 37

S/S of zinc toxicity

Back 37

Anemia, heart muscle degeneration

Front 38

Describe 3 documentation formats

Back 38

ADIME: Assessment, nutrition Diagnosis, Intervention, Monitoring, Evaluation
SOAP: Subjective, Objective, Assessment, Plan
DAR: Document, Assessment, Response

Front 39

Harris Benedict Equation for males

Back 39

Males = 66.47 + (13.75 x weight in kg) + (5.00 x height in cm) - (6.76 x age in years)

Front 40

Harris Benedict Equation for females

Back 40

Harris Benedict for females: 655.10 + (9.56 x weight in kg) + (1.85 x height in cm) - (4.68 x age in years)

Front 41

What does the nutrient claim "free" mean?

Back 41

No amount or a trivial amount of calories, fat, sat fat, cholesterol, sodium.

Front 42

What does the nutrient claim "calorie-free" mean?

Back 42

A "calorie-free" food must have less than 5 calories per serving.

Front 43

What does the nutrient claim "good source"(or "contains" or "provides") indicate?

Back 43

"Good source" is defined as 10-19% of the daily value of a certain nutrient per serving.

Front 44

What do the nutrient claims "high" (or "rich in" or "excellent source of") indicate?

Back 44

"High" is defined as more than 20% of the daily value of a certain nutrient per serving.

Front 45

What does the nutrient claim "less" indicate?

Back 45

"Less" is defined as having 25% less of a certain nutrient than a standard food.

Front 46

What does the nutrient claim "light" indicate?

Back 46

"Light" is defined as containing 1/3 less calories or 1/2 the fat of a standard food.

Front 47

What does the nutrient claim "low" indicate?

Back 47

"Low" is defined in certain nutrient terms.

Front 48

What does the nutrient claim "low fat" indicate?

Back 48

"Low fat" is defined as 3 grams or less of fat per serving

Front 49

What does the nutrient claim "low saturated fat" indicate?

Back 49

"Low saturated fat" is defined as 1 gram or less saturated fat per serving.

Front 50

What does the nutrient claim "low sodium" indicate?

Back 50

"Low sodium" is defined as 140 mg or less per serving.

Front 51

What does the nutrient claim "low calorie" indicate?

Back 51

"Low calorie" is defined as 40 calories or less per serving.

Front 52

What do the nutrient claims "more," "fortified," "enriched," "added," "extra," or "plus" indicate? (All defined in the same way)

Back 52

"More" et al is defined as containing 10% more of a nutrient's daily value when compared to a standard food.

Front 53

Diabetes is diagnosed when the A1C is at what level?

Back 53

Diabetes is diagnosed when the A1c is 6.5% or greater (diagnostic tests should be performed on 2 occasions to confirm diabetes diagnosis)

Front 54

Diabetes is diagnosed when the fasting blood glucose is at what level?

Back 54

Diabetes is diagnosed with a fasting blood glucose of 126 mg/dl or above (performed on 2 occasions to confirm diagnosis)

Front 55

Diabetes is diagnosed with a random glucose test is at what level?

Back 55

Random glucose test of greater than or equal to 200 mg/dl (performed on 2 occasions to confirm diagnosis)

Front 56

What is the goal for preprandial blood glucose?

Back 56

The goal for preprandial blood glucose is 80-120 mg/dl

Front 57

What is the goal for postprandial blood glucose test?

Back 57

The goal for postprandial blood glucose is <180 mg/dl

Front 58

What is the goal A1c levels for glycemic control in a person with diabetes?

Back 58

<7% is the goal A1c for an individual with diabetes

Front 59

Prediabetes is diagnosed when the blood glucose is at what level?

Back 59

Prediabetes is diagnosed when the blood glucose is 100-125 mg/dl.

Front 60

Prediabetes is diagnosed when the A1c is at what level?

Back 60

An A1c of 5.7% - 6.4% indicates prediabetes.

Front 61

How do you calculate grams of CHO needed by a diabetic?

Back 61

Total calorie needs x percentage of CHO = calories from CHO divided by 4 = grams CHO

Front 62

How do you calculate grams of protein needed?

Back 62

Total calorie needs x percentage of protein = calories from protein divided by 4 = grams protein

Front 63

How do you determine the grams of fat needed by an individual?

Back 63

Total calorie needs x percentage of fat = calories from fat divided by 9 = grams fat

Front 64

How do you determine and calculate exchanges (based on grams CHO, pro and fat)?

Back 64

First determine needs for milk, vegetables and fruits and calculate exchanges, i.e. grams CHO, pro and fat. Next, use remaining CHO for bread/starch exchanges; Then determine needs for meats and calculate exchanges; provide fat exchanges spread throughout the day using leftover fats (generally not more than 2-3 exchanges)

Front 65

What is a typical insulin to carbohydrate ratio to cover CHO eaten?

Back 65

Generally, 1 unit of rapid or short acting insulin to 15 g CHO (i.e. 45 g CHO consumed at dinner, 45 g/15g = 3 units of rapid or short acting insulin needed to cover CHO at dinner) *note insulin needs vary and must be individualized*

Front 66

What is the action onset, peak action, and effective duration of Lispro (Humalog) insulin?

Back 66

Lispro (Humalog) is a "rapid acting" insulin with action onset of <15 min, peak action of 1-2 hours, and effective duration of 3-4 hours.

Front 67

What is the action onset, peak action, and effective duration of Regular insulin

Back 67

Regular insulin is a "short acting" insulin with an action onset of 1/2 to 1 hour, peak action of 2-3 hours, and effective duration of 3-6 hours.

Front 68

What is the action onset, peak action, and effective duration of NPH insulin?

Back 68

NPH insulin is considered an "intermediate acting" insulin with action onset of 2-4 hours, peak action of 4-10 hours, and effective duration of 10-16 hours

Front 69

What is the action onset, peak action, and effective duration of Glargine (Lantus) insulin?

Back 69

Glargine (Lantus) is considered a "long acting" insulin with an action onset of 2-4 hours, no peak action, and effective duration of 20-24 hours.

Front 70

What is galactosemia and what dietary restriction is required?

Back 70

Galactosemia is a metabolic d/o that is characterized by inability to convert galactose to glucose due to an enzyme deficiency. Galactose restriction is required.

Front 71

What is gout?

Back 71

Gout is characterized by high concentrations of uric acid in the bloodstream, which can then build up in joints, causing pain typically in one joint. Need low purine diet - purines found mostly in organ meats, anchovies, mackerel, etc.

Front 72

What are the symptoms of hypoglycemia?

Back 72

Symptoms of hypoglycemia are: hunger, shakiness, nervousness, sweating, dizziness or light-headedness, sleepiness, confusion, difficulty speaking, anxiety, weakness.

Front 73

When blood glucose is less than ____, it is considered hypoglycemia.

Back 73

70 mg/dl: less than 70 is considered hypoglycemia

Front 74

How do you treat hypoglycemia

Back 74

15 g of CHO should be given, wait 15 min and retest. If blood glucose is still below 70 mg/dl, and additional 15 g of CHO should be given; repeat until blood glucose is back in normal range.

Front 75

What is phenylketonuria (PKU)?

Back 75

PKU is the inability to break down phenylalanine. Avoidance of high protein foods is required for this disorder; foods containing aspartame contains phenylalanine and should be eliminated.

Front 76

What is Prader-Willi syndrome?

Back 76

Prader-Willi syndrome is a genetic disorder characterized by mental disabilities, decreased muscle tone, persistent hunger than can lead to overeating and morbid obesity. Tx: Low calorie diet and limited access to food.

Front 77

What is diabetic ketoacidosis?

Back 77

DKA is due to inadequate insulin to allow the body to use CHO as an energy source; body uses fat instead resulting in ketone production. Characterized by high blood glucose (usu 250-600 mg/dl), polydipsia, polyuria, dehydration, and ketones in blood & urine; tx includes insulin, fluid and electrolyte replacement, etc.

Front 78

Name some nutritional concerns with cancer patients.

Back 78

Malnutrition, cachexia (tissue wasting) due to malnutrition, malabsorption, altered taste, hypermetabolism, nausea

Front 79

Treatment to aid in wt. maintenance in cancer pts include what?

Back 79

1. Kcal recs: 1.1-1.45 x BEE
2. Offer several small meals to reduce nausea
3. Comfort foods, frequent snacking, avoidance of dietary restrictions, and encourage pt to eat whenever they feel the urge
4. Avoid strong spices when mouth is sore and when taste aversions are found

Front 80

Vitamin B12 or folate deficiency can cause what type of anemia?

Back 80

Macrocytic - megaloblastic

Front 81

Iron deficiency causes what type of anemia?

Back 81

Hypochromic, microcytic; iron deficiency could be due to chronic loss of blood, diet, malabsorption.

Front 82

Normocytic, normochromic anemia may occur in what circumstances?

Back 82

Pregnancy, renal disease, overhydration

Front 83

ATP III Therapeutic Lifestyle Changes (TLC) recommendations for fat intake.

Back 83

<7% saturated fat, up to 10% PUFA, up to 20% monounsaturated fat, <200 mg cholesterol,

Front 84

ATP III (TLC) recommendations for % of kcal distributions for total fat, CHO, pro.

Back 84

25-35% calories from total fat, 50-60% kcal from CHO, 20-30 g fiber, ~15% from protein

Front 85

DASH diet plan includes what?

Back 85

Limited sodium, rich in calcium, magnesium, fiber.

Front 86

Symptoms of Crohn's disease.

Back 86

Anorexia, blood loss, diarrhea, fatigue

Front 87

Treatment for Crohn's disease.

Back 87

Low fiber diet (during acute inflammation), include adequate kcal and pro; medications

Front 88

Cystic fibrosis is inability of _______ ________ to function correctly in the body.

Back 88

Exocrine glands

Front 89

Treatment of cystic fibrosis.

Back 89

High calorie and protein diet, vitamin supplements, pancreatic enzymes.

Front 90

Dumping syndrome treatment

Back 90

Several small meals throughout the day, usu high in protein and fat with low CHO to prevent quick dumping into the jejunum.

Front 91

Dumping syndrome symptoms

Back 91

Cramping, weakness, n/v, diarrhea, quickly after consuming a meal

Front 92

Short bowel syndrome cause

Back 92

Resections of small intestine

Front 93

Short bowel syndrome treatment

Back 93

TPN may be initially indicated depending on extent of resection (in some cases TPN may be long term/permanent) progression to nutrition by mouth as tol; several small meals instead of 3 large meals may be better tolerated.

Front 94

Recommendations for liver cirrhosis

Back 94

Adequate kcal and pro, with restricted fluid and sodium generally recommended.

Front 95

End stage liver disease is characterized by ____? (3)

Back 95

ESLD is characterized by ascites, encephalopathy, and portal hypertension.

Front 96

Treatment for end stage liver disease.

Back 96

Adequate kcal (increased kcal with ascites or malabsorption), vitamin and mineral supplementation in part due to the liver's extensive role in utilizing these nutrients.

Front 97

What is the treatment for hepatic encephalopathy?

Back 97

Branched chain amino acid (leucine, isoleucine, valine "liv") enriched formulas may be indicated among pts with severe encephalopathy who do not respond or comply with lactulose or do not tolerate standard protein.

Front 98

What is pancreatitis?

Back 98

Inflammation of the pancreas; may be acute or chronic. Symptoms include cramping and diarrhea

Front 99

Treatment of pancreatitis.

Back 99

Pancreatic enzymes, low fat diet, and avoidance of alcohol.

Front 100

Osteoporosis

Back 100

Progressive bone loss associated with increased risk of fractures. Characterized by increased risk for fx, loss of height, and curvature of upper spine.

Front 101

Risk factors for osteoporosis

Back 101

Female gender, Caucasian or Asian ethnicity, post menopausal, inactivity, smoking, excessive alcohol.

Front 102

The name for curvature of the upper spine

Back 102

Dowager's hump

Front 103

Treatment for osteoporosis

Back 103

Calcium and vit D may slow progression, weight bearing exercises, estrogen replacement therapy, medications to decrease bone loss.

Front 104

What is Glomerulonephritis?

Back 104

Inflammation of renal glomeruli; can be acute or chronic.

Front 105

Symptoms of glomerulonephritis (3)

Back 105

Edema, HTN, proteinuria

Front 106

Treatment of glomerulonephritis

Back 106

Fluid control, protein control, adequate calories

Front 107

Acute renal failure is characterized by what?

Back 107

Decreased Glomerular Filtration Rate (GFR) and change in the kidneys' ability to excrete waste.

Front 108

Acute renal failure nutritional care

Back 108

Nutritional care is based on lab values and recovery; protein, fluids, phosphorus, calcium, potassium, and sodium should all be considered.

Front 109

Characteristics of End Stage Renal Disease

Back 109

Decreased ability to excrete waste, diminished fluid and electrolyte balance, uremia.

Front 110

What is uremia?

Back 110

Excessive amounts of nitrogen waste in the blood characterized by n/v, weakness, etc. Results from ESRD.

Front 111

Treatment of End Stage Renal Disease (ESRD)

Back 111

Dialysis or transplantation; nutrition care - protein is increased, potassium phosphorus, sodium and fluids are monitored, nutrient recommendations vary based on treatment.

Front 112

Which of the following is the best information source for nutrient content in foods?
a. FDA food values
b. USDA Food Guide Pyramid
c. FDA Handbook on Food
d. USDA Handbook No. 8

Back 112

d. USDA Handbook No. 8
The USDA Handbook No. 8 is a standard reference of nutrient composition in foods.

Front 113

57. Which mineral is required for blood coagulation?
a. magnesium
b. calcium
c. potassium
d. zinc

Back 113

b. Calcium
Calcium aids in blood coagulation, nerve and muscle contraction, and mineralization of bones and teeth.

Front 114

A client at the WIC clinic reveals she has been giving her 6 month old whole cow's milk instead of breast milk. Nutritional differences include:
a. cow's milk is lower in CHO and higher in protein
b. cow's milk is higher in CHO and lower in calcium
c. cow's milk is higher in fat and higher in kcal
d. cow's milk is higher in kcal and lower in protein

Back 114

a. Cow's milk is lower in CHO and higher in protein.
Cow's milk is lower in kcal, CHO, and fat, and higher in protein and calcium in comparison to breast milk.

Front 115

Which of the following is NOT a function of sodium in the body?
a. major ion of extracellular fluid
b. major ion of intracellular fluid
c. maintains fluid balance
d. aids in nerve impulse transmission

Back 115

b. Major ion of intracellular fluid
Sodium is a major ion of extracellular fluid, aids in maintaining fluid balance, and aids in nerve transmission. Potassium is an example of an ion of intracellular fluid.

Front 116

When storing milk in a clear container, which of the following vitamins are you concerned with being destroyed? Correct
a. riboflavin
b. vitamin B3
c. vitamin A
d. vitamin B12
Riboflavin is easily destroyed when exposed to light.

Back 116

a. riboflavin
Riboflavin is easily destroyed when exposed to light.

Front 117

An endurance athlete is concerned with fluid consumption. How much water do you recommend he consumes during a training bout?
a. 6-12 fl oz every 15-20 minutes
b. 4-6 fl oz every 15-20 minutes
c. 6-12 fl oz every 30 minutes
d. 4-6 fl oz every 30 minutes

Back 117

a. 6-12 fl oz every 15-20 min

Front 118

Which of the following is NOT a function of folate?
a. DNA synthesis
b. metabolism of amino acids
c. red blood cell maturation
d. fat metabolism

Back 118

d. fat metabolism
Folate functions include DNA synthesis, metabolism of amino acids, and red blood cell maturation

Front 119

The process of Beta oxidation involves:
a. the breakdown of fatty acids to acetyl CoA
b. the use of lipoprotein lipase for fat storage
c. transport of fats in a fed state
d. none of these

Back 119

a. the breakdown of fatty acids to acetyl CoA.
Beta oxidation involves the breakdown of fatty acids to acetyl CoA which is then used for energy production via the Krebs cycle.

Front 120

In glycogenolysis, _____ is converted to glucose.
a. glucose 6-phosphate
b. OAA
c. pyruvate
d. none of these

Back 120

a. glucose 6-phosphate.
In glycogenolysis, glucose 6-phosphate is converted to glucose.

Front 121

Which of the following combines with CoA in 2 carbon fragments to make acetyl CoA to then enter the Krebs Cycle to make energy?
a. glucose
b. fatty acids
c. fructose
d. lactic acid

Back 121

b. fatty acids
In fatty acid oxidation, fatty acids are broken apart to 2 carbon fragments, and combine with CoA to make acetyl CoA

Front 122

Long chain fatty acids enter the liver in the form of ______ (make up mostly triglycerides) and leave the liver in the form of lipoprotein.

Back 122

Chylomicrons

Front 123

____ signals contraction of the gallbladder to release bile to aid in fat digestion and secretion of pancreatic juices.

Back 123

Cholecystokinin

Front 124

Which of the following is true about VLDL cholesterol?
a. composed primarily of cholesterol
b. carries cholesterol out of the liver for excretion
c. composed primarily of protein
d. carries cholesterol and lipids synthesized by the liver out from the liver

Back 124

d. carries cholesterol and lipids synthesized by the liver out from the liver.
VLDL cholesterol carries cholesterol and lipids synthesized by the liver out from the liver. VLDL transports triglycerides to cells and picks up cholesterol, ultimately becomes LDL cholesterol.

Front 125

The net number of ATP molecules produced from glycolysis is:
a. 4
b. 36
c. 2
d. 0

Back 125

c. 2
Glycolysis requires 2 molecules of ATP and provides 4 molecules of ATP = 2 molecules ATP net produced.

Front 126

Which of the following is true of LDL cholesterol?
a. product of VLDL cholesterol breakdown
b. comprised primarily of triglyceride
c. aids in excretion of cholesterol
d. none of these

Back 126

a. product of VLDL cholesterol breakdown.
LDL cholesterol is a product of VLDL cholesterol breakdown. As VLDL transports triglycerides to cells and picks up cholesterol it eventually Becomes LDL cholesterol (LDL make up is high in cholesterol).

Front 127

When fats are oxidized for energy which of the following is produced?
a. urea
b. pyruvate
c. glucose-6-phosphate
d. acetyl CoA

Back 127

d. acetyl CoA
Fat oxidation produces acetyl CoA

Front 128

You have identified that those at risk for type 2 diabetes at a local clinic are in need of nutrition education. Which step of screening have you completed?
a. selection
b. parameters
c. methodology
d. purpose

Back 128

d. purpose
Purpose involves identifying those who are in need of nutrition education/intervention

Front 129

A1c tests and patient interviews of those at risk for type 2 diabetes will be used to screen participants. This is an example of:
a. methodology
b. purpose
c. selection
d. parameters

Back 129

a. methodology
Methodology identifies how to screen and may include interviews or medical charts.

Front 130

A senior citizen fills out a self assessment nutrition health tool at the local senior center. What level of NSI assessment is this?
a. DETERMINE
b. ASSESS
c. Level I
d. Level II

Back 130

a. DETERMINE
NSI developed by American Academy of Physicians, American Dietetic Association, and National Council on Aging to focus on improved nutrition status of elderly. DETERMINE your nutrition health - focus on raised awareness for public; can be used as a self assessment tool.

Front 131

A social worker visiting a Meals on Wheels participant identifies the senior as needing more comprehensive follow up based on eating habits. What level of assessment of the NSI is this?
a. Level II
b. Level III
c. Level I
d. DETERMINE

Back 131

c. level 1
Level 1 screen identifies who should be referred for a more comprehensive follow up and/or other community services. Includes eating habits, recent weight loss, etc.

Front 132

When chyme enters the small intestine it becomes:
a. acidic in pH
b. basic in pH
c. neutral in pH
d. waste

Back 132

c. neutral in pH
Bicarbonate in the pancreatic juices aids in neutralizing the acidic chyme. Chyme is acidic in the stomach but is neutralized in the intestine.

Front 133

Tryptophan aids in the synthesis of:
a. niacin
b. thiamin
c. riboflavin
d. vitamin D

Back 133

a. niacin
Niacin can be synthesized from tryptophan. About 1 mg of niacin is made from 60 mg of dietary tryptophan. Vitamin B6 is needed for this conversion

Front 134

A patient taking phenytoin may experience which of the following?
a. decreased serum calcium and folate levels
b. decreased vitamin B2 and B6 levels
c. decreased magnesium and folate levels
d. decreased serum magnesium and calcium levels

Back 134

a. decreased serum calcium and folate levels.
Serum calcium and folate levels can be decreased due to central nervous system medications including Phenytoin and Phenobarbital.

Front 135

Creatinine Height Index is an indicator of lean body mass when:
a. renal function is normal
b. fluid intake is adequate
c. all of these
d. no presence of rapid muscle breakdown

Back 135

c. all of these
Creatinine height index is an index of lean body mass; indicator when renal function is normal, fluid intake is adequate, and there is no presence of rapid muscle breakdown.

Front 136

A woman has pale conjunctiva
and dry, scaly skin. What nutrient deficiency might this be an indicator of?
a. vitamin A
b. protein
c. vitamin C
d. thiamin

Back 136

a. vitamin A
Vitamin A deficiency characteristics include pale conjunctiva and dry scaly skin.

Front 137

A patient has been diagnosed with hypochromic anemia. Which of the following nutrients may help with this disorder?
a. Cobalamin
b. Folate
c. Pyridoxine
d. Thiamin

Back 137

c. pyridoxine
Pyridoxine (B6) deficiency includes hypochromic, microcytic anemia.

Front 138

All of the following nutrient toxicities may lead to kidney stones except:
a. vitamin C
b. vitamin D
c. calcium
d. vitamin A

Back 138

d. vitamin A
Vitamins C, D, and calcium may lead to kidney stones when taken in toxic amounts.

Front 139

Males with WHR (waist:hip ratio) of ___or greater and females with WHR of ____or greater can indicate android obesity and risks for disease associated (ie: heart disease, type 2 diabetes, etc.)

Back 139

1.0 - males
0.8 - females

Front 140

Nutrition treatment for chronic obstructive pulmonary disease (COPD)

Back 140

Increased energy to aid in maintaining adequate body weight. Micronutrients to support a favorable respiratory quotient (RQ) - fat 30-45% of calories, protein 15-20% of calories, CHO 40-55% of calories

Front 141

What acid/base imbalance is characterized by a reduced pCO2 and/or pH, with causes such as starvation, low CHO diet, diabetic ketosis, uremia?

Back 141

Metabolic acidosis.

Front 142

What acid/base imbalance is characterized by increased pH and bicarbonate, with causes such as diuretic use or persistent vomiting?

Back 142

Metabolic alkalosis.

Front 143

What acid/base imbalance is characterized by reduced pH and is generally due to reduced breathing (hypoventilation) secondary to COPD, emphysema, or asthma?

Back 143

Respiratory acidosis.

Front 144

What acid/base imbalance is characterized by increased pH and generally due to increased breathing (hyperventilation)

Back 144

Respiratory alkalosis.

Front 145

How does the body compensate for metabolic acidosis?

Back 145

Lungs try to exhale carbon dioxide (breathing is increased); kidneys increase hydrogen secretion and increase ammonia production.

Front 146

How does the body compensate for metabolic alkalosis?

Back 146

Lungs attempt to preserve CO2 (breathing decreases); kidneys decrease hydrogen secretion and increase bicarbonate excretion.

Front 147

How does the body compensate for respiratory acidosis?

Back 147

Increase bicarbonate resorption.

Front 148

How does the body compensate for respiratory alkalosis?

Back 148

Increase bicarbonate excretion.

Front 149

Which of the following is NOT usually needed for supplementation in breast fed infants?
a. iron
b. fluoride
c. vitamin D
d. zinc

Back 149

d. zinc
Zinc is highly absorbable and does not usually require supplementation.

Front 150

1 gram dextrose = _____ kcal

Back 150

3.4 kcal

Front 151

1 gram protein = _____ kcal

Back 151

4 kcal

Front 152

Lipids in TPN sol'n:
10% fat = ___ kcal/mL
20% fat = ___ kcal/mL
30% fat = ___ kcal/mL

Back 152

10% fat = 1.1 kcal/mL
20% fat = 2.0 kcal/mL
30% fat = 3.0 kcal/mL

Front 153

What percent of kcals should amino acids be in TPN?

Back 153

~12-15% kcals

Front 154

How much calcium should be in TPN?

Back 154

0.2 - 0.3 mEq/kg

Front 155

How much chloride is in TPN?

Back 155

1-2 mEq/kg (same as sodium)

Front 156

How much sodium is in TPN?

Back 156

1-2 mEq/kg (same as chloride)

Front 157

How much potassium is in TPN?

Back 157

1 mEq/kg

Front 158

What is the formula for calculating milliequivalents (mEq) from mg.

Back 158

mEq = (mg. divided by atomic weight) x valence
ex. how many mEq are in 2000 mg sodium? (2000/23) x 1 = 87 mEq

Front 159

What is the atomic weight and valence of calcium?

Back 159

Atomic weight = 40
Valence = 2

Front 160

What is the atomic weight and valence of chlorine?

Back 160

Atomic weight = 35.4
Valence = 1

Front 161

What is the atomic weight and valence of potassium?

Back 161

Atomic weight = 39
Valence = 1

Front 162

What is the atomic weight and valence of sodium?

Back 162

Atomic weight = 23
Valence = 1

Front 163

A low fiber diet may be used for what conditions?

Back 163

Nausea, gastritis, diverticulitis, or IBS.

Front 164

What foods should be avoided on a low fiber diet?

Back 164

berries, several raw fruits, legumes, and vegetables, whole grain breads, yogurt containing seeds, peanut butter.

Front 165

What is a low residue diet?

Back 165

Includes total amount of material in colon; foods to avoid include high fiber foods as well as milk or potatoes.

Front 166

What type of diet is followed when a fecal fat test is performed?

Back 166

Instructions include eating 100 g of fat each day for 3 days before collection of stool and during the 3 days of collection one should continue with 100 g of fat each day.

Front 167

How is a glucose tolerance test performed?

Back 167

A blood sample prior to taking ~75 g of CHO, followed by additional blood sample.

Front 168

When calculating nutrition support, ml x % = _____

Back 168

Grams

Front 169

A patient is receiving an 1800 ml solution with 25% dextrose, 7.5% amino acids. The patient also receives 250 ml of 30% lipids twice a week. How many calories does this patient average on a daily basis?
a. 2600 kcal
b. 2100 kcal
c. 2300 kcal
d. 1500 kcal

Back 169

c. 2300 kcal
Dextrose = 1800 ml x 25% = 450 g x 3.4 kcal/g = 1530 kcal; amino acids = 1800 x 7.5% = 135 g x 4 kcal/g = 540 kcal; lipids = 250 ml x 3.0 kcal/ml = 750 kcal x 2 days per week = 1500 kcal divided by 7 days per week = 214 kcal; 1530 + 540 + 214 = 2284 kcal; the best answer is 2300 kcal

Front 170

A patient weighs 125 lbs and receives 2200 kcals via TPN. How many grams of nitrogen is given if the ratio is 150/1?
a. 18
b. 10
c. 20
d. 15

Back 170

d. 15
2200 kcal divided by 150 = 15 grams nitrogen

Front 171

A patient with a GFR of 35 ml/min and oliguria is being treated for acute renal failure. You recommend: Correct
a. 1.0 g protein/kg and unrestricted fluids
b. .5-.8 g protein/kg and 500 ml fluids
c. .5-.8 g protein/kg and 24 hour output of fluids plus 500 ml
d. none of these

Back 171

C. With acute renal failure and a pt. experiencing oliguria, protein is recommended to be .5-.8 g/kg and the last 24 hours of fluid output plus 500 ml.

Front 172

Multiply BEE x ____ for weight maintenance

Back 172

1.3

Front 173

Multiply BEE x ____ for weight gain

Back 173

1.5

Front 174

A patient weighs 175 lbs and receives 2700 kcals via TPN. How many grams of nitrogen are given if the ratio is 200/1? Correct
a. 18
b. 10
c. 20
d. 14

Back 174

d. 14
2700 kcals divided by 200 = 14 grams of nitrogen.