University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Test consists of 40 questions, each question – 1 point; total-40 points
1. Adequate maternal folate intake around the time of conception helps prevent
a. growth retardation.
b. fetal anemia.
c. neural tube defects.
d. maternal hypertension
2. George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
a. George should start parenteral nutrition for 4-8days because weight loss is severe
b. George has no stomach, but the rest of his gut still works, so he should receive enteral
nutrition support. He should be fed via a jejunostomy, below the site of the gastrectomy.
Feedings should be continuous over 12 to 24 hours of each day.
c. There is no Need for enteral nutrition. George should avoid high amount of simple
carbs, sweet food in order to reduce dumping syndrome. He should increase fibers and
protein in his diet
3. The amount of energy required by the body for maintenance of life when a person is at
complete digestive, physical, and emotional rest is referred to as
a. the recommended dietary intake.
b. the estimated energy expenditure.
c. the daily energy requirement.
d. the basal energy expenditure.
4. Adam is a healthy 12-year-old.. Adam quit football. On school days he takes the bus
home from school and usually plays video games and watches television until his
parents come home. By the end of the day, his parents are so tired and hungry that they
often pick up fast food on the way home or put a frozen pizza in the oven. Adam’s
weight is in the overweight range for his height. Do the Adam’s overweight status affect
his health risks?
a. Adam has a higher risk for type 2 diabetes and metabolic syndrome.
b. Adam has a higher risk for CKD and pancreatic dysfunction
c. Adam has a higher risk for type 1 diabetes and neuropathy
5. Which kind of recommendation you would suggest Adam and his parents from question
4?
a. Adam just needs to increase the activity (start playing football) no need to
change the nutrition
b. Adam needs to increase his activity level and decrease his energy intake. He
needs to focus on developing healthy habits
c. Adam should only decrease amount of fat and increase amount of fiber in food,
and ask to visit you after 6 month to see the results
6. Sarah has had stomach pain she has been diagnosed with a duodenal ulcer and given a
prescription for an antibiotic. She also has been told to take famotidine (Pepcid) daily
and to use antacids as needed when she has stomach pain. Which food Sarah should
avoid?
a. Sarah should avoid very hot and very cold food, ice cream, milk products and
fibers
b. Sarah should avoid hot chili peppers, black pepper, and chili powder. She may
find it helpful to avoid caffeine, chocolate, and alcohol
c. Sarah should avoid alcohol and carb rich food
7. Nutrients are
a. chemical elements or compounds in foods that have specific metabolic
functions within the body.
b. whole foods that are necessary for good health.
c. exclusively energy-yielding compounds.
d. nourishing foods used to cure certain illnesses
8. All nutrients needed by the body
a. must be obtained by specific food combinations.
b. must be obtained by vitamin or mineral supplements.
c. have only one function and use in the body.
d. are supplied by a variety of foods in many different combinations.
9. In the following family of four, who has the highest energy needs per unit of body
weight?
a. 32-year-old mother
b. 35-year-old father
c. 2-month-old son
d. 70-year-old grandmother
10. Frank is 65 years old and is retiring from his teaching job. He has gained weight
gradually up to 8 kg but he does not think he has changed his eating habits or exercise
routine. Why would Frank have gradually gained weight if his food intake and activity
level have not changed?
a. Resting metabolic rate decreases as part of the normal aging process because
muscle mass and basal metabolic rate both gradually decrease with age.
b. Frank can have ulcerative colitis which could lead to malnutrition
c. Frank can have dumping syndrome - body uses less energy than he used to for the
same activities.
11. Which test you will order for Frank from question 10?
a. Measuring blood levels of the hormone testosterone
b. Measuring blood levels of the hormone thyroxine
c. Measuring blood levels of the Iron
12. The increase in metabolic rate after a meal is called
a. satiety.
b. the metabolic stimulus.
c. the thermic effect of food.
d. the postmeal effect.
13. Malnutrition often is caused by
a. acute illness.
b. skipping meals.
c. regular exercise.
14.
15.
16.
17.
18.
19.
20.
21.
d. prolonged hospitalization.
While performing a nutritional assessment of a low-income family to nurse determines that
the family’s diet is inadequate in protein content. You suggests which of the following foods
to increase protein content?
a. Oranges and potatoes
b. Potatoes and rice
c. Rice and macaroni
d. Peas and beans
A new mother is breast-feeding her infant and asks the nurse about the introduction of
cereals into the diet. Your best response is:
a. "Be sure to test the temperature of the cereal if you use your microwave, as it is easy to
get it too hot. "
b. "You can begin feeding iron-fortified cereals between 4 and 6 months. "
c. "Integrate feeding vegetables and fruit with your cereals at about 1.5-2 months of age’’
A school nurse suspects that one of the junior high students may have anorexia nervosa.
This eating disorder is characterized by:
a. A lack of control over eating patterns
b. Self-imposed starvation
c. Binge-purge cycles
d. Excessive exercise
A patient is pregnant for the third time. In regard to her nutritional status, she should:
a. Limit her weight gain to a maximum of 4 kg
b. Approximately double her protein intake
c. Increase her vitamin A and milk product consumption
d. Increase her intake of folic acid
Which of the following foods is a complete protein?
a. Eggs
b. Oats
c. Lentils
d. Peanuts
Pregnant teens who have a low weight gain by 20 weeks’ gestation may be at most risk for
a. gestational diabetes.
b. intrauterine growth failure.
c. a neural tube defect in the baby.
d. bone fractures.
Which of the following is the most accurate statement regarding the functions of protein?
a. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
b. Proteins are a necessary nutrient to provide energy for the body in times of stress.
c. Proteins can be used as coen>yme factors during cell metabolism.
d. Proteins are essential to tissue building and repair within the body
The main nutrients involved in metabolic regulation and control are
a. water and vitamins.
b. vitamins and minerals.
c. vitamins and fatty acids.
d. minerals and carbohydrates.
22. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
a. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
b. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
c. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
d. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
23. A young woman is 5 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
a. liver damage.
b. osteopenia.
c. undernutrition.
d. overnutrition.
24. Hich factors place a person at the greatest risk for malnutrition?
a. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
b. poor hygiene insufficient exercise and excess carbohydrate intake
c. depleted carbohydrate intake poor hygiene and excess calorie intake
d. poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
25. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
a. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
b. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
c. Even though excess body fat and excess nutrient intake are evident there still may be
a risk for some type of nutrient deficiency leading to malnutrition.
d. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
26. Which is least likely to be a primary cause of malnutrition?
a. Conditions of poverty
b. Prolonged hospitalization
c. Homelessness
d. Exercise
27. Overnutrition is characterized by
a. overeating at a meal.
b. excess nutrient and energy intake over time.
c. eating a diet with too much variety.
d. using dietary supplements
28. The Dietary Reference Intakes (DRI) address the nutrient needs of
a. all adults.
29.
30.
31.
32.
33.
34.
b. most healthy population groups.
c. minority ethnic groups.
d. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
a. Dietary reference intakes.
b. Dietary Guidelines for Americans.
c. MyPlate food guidance system.
d. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate response
would be to
a. eat a variety of foods and eat in moderation.
b. eat only natural, organic foods.
c. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
a. Variety, proportion moderation, gradual improvements, and physical activity.
b. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
c. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
d. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast food
restaurants at least twice a week and relies on processed foods for the majority of her dietary
intake. She maintains an active lifestyle and works part time at the local bank. The next
step toassist this woman would be to
a. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
b. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
c. recommend that she use the MyPlate food guide to change her eating style. Assess meal
plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
a. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
b. Young child who refuses to eat peas, green beans and broccoli but loves fruits and other
vegetables.
c. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
d. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats soup
35.
36.
37.
38.
39.
or a salad and meat along with 2% milk and a sugared soda. He usually has an afternoon
snack of chips and sugared soda and dinner is eaten at a restaurant most days of the week
where he chooses steaks, hamburgers and fries or onion rings along with a salad anda beer
or other high- calorie beverage. One of the most important recommendations for D.C.
would be
a. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
b. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
c. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the week
Medical nutrition therapy for congestive heart failure usually includes
a. increased fluid intake.
b. decreased protein intake.
c. sodium restriction.
d. potassium restriction.
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how to
control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
a. You will not encourage Vicky to run because it is too risky for her health
b. You will advice Vicky to run but only a small distance (max 20-25minutes)
c. You will encourage Vicky to run only if she will take extra carbs and fat before the run,
sufficient amount of water during the running and after the running extra amount of
protein
d. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 36?
a. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need extra
insulin; if she also has ketosis, she should not run. Before a run, if her blood glucose
level is below 100 mg/dL, she should have a snack before she runs
b. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need extra
insulin. Before a run, if her blood glucose level is below 200 mg/dL, she should have a
snack before she runs
c. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need protein.
Before a run, if her blood glucose level is below 200 mg/dL, she should increase intake
of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
a. Hot chili peppers, black pepper, and chili powder.
b. Mint tea, sugar, apple and banana
c. Potatoes, cucumber and beans
Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
a. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
b. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
40. Quinn had stomach cancer and had to have most of his stomach removed. He has recovered
quite well and usually manages to eat six small meals a day. Sometimes he experiences
cramps, nausea, sweating, and weakness after he eats. What do you think what could be the
reason for this symptoms and which food Quinn should avoid?
a. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar, alcohol,
or sweet sodas
b. Celiac disease, Quinn should avoid Gluten consisting food
c. Diabetes Mellitus Type I, starting insulin therapy
d. Gastric ulcer. Quinn should avoid caffeine and chocolate
41. Which of the following is the most accurate statement regarding the functions of protein?
e. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
f. Proteins are a necessary nutrient to provide energy for the body in times of stress.
g. Proteins can be used as coen>yme factors during cell metabolism.
h. Proteins are essential to tissue building and repair within the body
42. The main nutrients involved in metabolic regulation and control are
e. water and vitamins.
f. vitamins and minerals.
g. vitamins and fatty acids.
h. minerals and carbohydrates.
43. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
e. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
f. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
g. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
h. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
44. A young woman is < months pregnant. $he currently lives in a condition of poverty and
often runs out of money to buy food. $he is most at ris8 for
e. liver damage.
f. osteopenia.
g. undernutrition.
h. overnutrition.
45. Hich factors place a person at the greatest risk for malnutrition?
e. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
f. poor hygiene insufficient exercise and excess carbohydrate intake
g. depleted carbohydrate intake poor hygiene and excess calorie intake
h. poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
46. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
e. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
f. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
g. Even though excess body fat and excess nutrient intake are evident there still may be
a risk for some type of nutrient deficiency leading to malnutrition.
h. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
47. Which is least li8ely to be a primary cause of malnutrition?
e. Conditions of poverty
f. Prolonged hospitali>ation
48.
49.
50.
51.
52.
53.
54.
g. Homelessness
h. Exercise
Overnutrition is characterized by
e. overeating at a meal.
f. excess nutrient and energy intake over time.
g. eating a diet with too much variety.
h. using dietary supplements
The (ietary ,eference )nta8es 5(,)s6 address the nutrient needs of
e. all adults.
f. most healthy population groups.
g. minority ethnic groups.
h. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
e. Dietary reference intakes.
f. Dietary Guidelines for Americans.
g. MyPlate food guidance system.
h. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate
response would be to
d. eat a variety of foods and eat in moderation.
e. eat only natural, organic foods.
f. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
e. Variety, proportion moderation, gradual improvements, and physical activity.
f. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
g. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
h. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast
food restaurants at least twice a week and relies on processed foods for the majority of her
dietary intake. She maintains an active lifestyle and works part time at the local bank. The
next step toassist this woman would be to
d. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
e. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
f. recommend that she use the MyPlate food guide to change her eating style. Assess
meal plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
55.
56.
57.
58.
e. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
f. Young child who refuses to eat peas, green beans and broccoli but loves fruits and
other vegetables.
g. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
h. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats
soup or a salad and meat along with 2% milk and a sugared soda. He usually has an
afternoon snack of chips and sugared soda and dinner is eaten at a restaurant most days of
the week where he chooses steaks, hamburgers and fries or onion rings along with a salad
anda beer or other high- calorie beverage. One of the most important recommendations
for D.C. would be
e. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
f. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
g. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
h. to enjoy his diet as is but encourage adequate amounts of exercise throughout the
week
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how
to control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
e. You will not encourage Vicky to run because it is too risky for her health
f. You will advice Vicky to run but only a small distance (max 20-25minutes)
g. You will encourage Vicky to run only if she will take extra carbs and fat before the
run, sufficient amount of water during the running and after the running extra
amount of protein
h. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 16?
d. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need
extra insulin; if she also has ketosis, she should not run. Before a run, if her blood
glucose level is below 100 mg/dL, she should have a snack before she runs
e. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need
extra insulin. Before a run, if her blood glucose level is below 200 mg/dL, she
should have a snack before she runs
f. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need
protein. Before a run, if her blood glucose level is below 200 mg/dL, she should
increase intake of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
d. Hot chili peppers, black pepper, and chili powder.
e. Mint tea, sugar, apple and banana
f. Potatoes, cucumber and beans
59. Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
c. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
d. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
60. Quinn had stomach cancer and had to have most of his stomach removed. He has
recovered quite well and usually manages to eat six small meals a day. Sometimes he
experiences cramps, nausea, sweating, and weakness after he eats. What do you think
what could be the reason for this symptoms and which food Quinn should avoid?
e. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar,
alcohol, or sweet sodas
f. Celiac disease, Quinn should avoid Gluten consisting food
g. Diabetes Mellitus Type I, starting insulin therapy
h. Gastric ulcer. Quinn should avoid caffeine and chocolate
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Test consists of 40 questions, each question – 1 point; total-40 points
1. Troy is 54 and works as an insurance adjuster, which means he sits all day. Over the
past 10 years, he has gradually gained weight and is now about 18kg overweight. In the
past few weeks he has been experiencing severe pain after eating, especially if he eats
fried or rich foods. What is the most likely cause of Troy’s pain?
a. Troy probably has ulcerative colitis, pain would be caused by the ulcers in colon.
b. Troy probably has gallbladder disease. The pain would be caused by
inflammation of the gallbladder (cholecystitis) or gall stones (cholelithiasis)
c. Troy probably has celiac disease, pain would be caused by the inflammation in the
small intestine.
2. What nutritional recommendations would you make to Troy form question 1?
a. Troy should reduce his fat intake. This would help him lose weight and would
reduce contraction of the gallbladder via the cholecystokinin mechanism
b. Troy should exclude protein gluten from his diet, this will reduce the inflammation in
intestines and help the normal absorption
c. Troy should avoid spice and hot food from his diet which will reduce the formation of
ulcers in the colon
3. Nick had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost
about 5kg since the surgery. Which kind of nutrition support Nick needs?
a. He should receive parenteral nutrition support by the central venous access after
1 week it should be changed by parenteral nutrition support by the peripheral
venous access
b. He should receive enteral nutrition support. He should be fed via a
jejunostomy, below the site of the gastrectomy.
4. Which of the following is the most accurate statement regarding the functions of protein?
i. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
j. Proteins are a necessary nutrient to provide energy for the body in times of stress.
k. Proteins can be used as coen>yme factors during cell metabolism.
l. Proteins are essential to tissue building and repair within the body
5. The main nutrients involved in metabolic regulation and control are
i. water and vitamins.
j. vitamins and minerals.
k. vitamins and fatty acids.
l. minerals and carbohydrates.
6. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
i. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
j. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
k. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
l.
with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
7. Sonja has severe ulcerative colitis. She is able to eat small amounts, but severe diarrhea
prevents her from eating enough to maintain a healthy weight and nutritional status
a. Sonja will need parenteral nutrition support because she cannot absorb
sufficient nutrients because of the ulcerative colitis. She will probably need a
central line, because she is likely to need parenteral nutrition for longer than
14 days.
b. Sonja needs enteral nutrition gastrostomy for 2-3 days, after that she should avoid
irritating foods such as hot chili peppers, black pepper, and chili powder. She may
find it helpful to avoid caffeine, chocolate, and alcohol
8. Health problems that have been shown to be related to obesity include
a. Kidney disease and heart disease.
b. Heart disease and diabetes.
c. Diabetes and anemia.
d. Anemia and arthritis.
9. A young woman is 4 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
i. Liver damage.
j. Osteopenia.
k. Undernutrition.
l. Overnutrition.
10. Jane is approximately 8 weeks pregnant. She felt good at first, but for the last 2 weeks
she has had mild nausea throughout the day. She has not had much appetite and has lost
a few pounds. She knows she should probably eat more, but she is finding eating to be
difficult. What would you suggest to help Jane eat more?
a. Jane should eat small, frequent meals, with a small meal or snack
approximately every 2 hours. She also could try drinking liquids between
meals rather than with meals.
b. Jane needs a supply of high-carbohydrate and fat and modarate-protein snacks. She
needs to increase amount of fibers and in her diet.
11. Sports drinks or other electrolyte replacement aids:
a. Should not be necessary unless the event lasts longer than 1 hour. For events
lasting 1+ hours, beverages containing 6% - 8% glucose concentrations are
recommended.
b. They are not necessary unless the event last longer than 2 hours. For events lasting
2+ hours, beverages containing 20% - 25% glucose concentrations are
recommended.
12. An overactive thyroid causes
a. Decreased energy need.
b. No effect on energy need.
c. Increased energy need.
d. Decreased protein need.
13. Hich factors place a person at the greatest risk for malnutrition?
i. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
j. poor hygiene insufficient exercise and excess carbohydrate intake
k. depleted carbohydrate intake poor hygiene and excess calorie intake
l.
poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
14. An eating disorder characterized by gorging on food and then inducing vomiting is
a. anorexia nervosa.
b. bulimia nervosa.
c. hyperemesis.
d. binge eating disorder.
15. Frank is 65 years old. He always gains a few pounds during the school year and loses
them again during the summer, when he is able to be more active. During the last few
years he has gained a few more pounds than he has lost and is now approximately 7kg
heavier than his ideal body weight. He does not think he has changed his eating habits
or exercise routine, so he is surprised that he has gradually gained weight.
a. Franks weight gain can be explained by having metabolic syndrome and diabetes
mellitus type 2.
b. Franks resting metabolic rate decreases as part of the normal aging process
because muscle mass and basal metabolic rate both gradually decrease with
age
c. Frank can have stomach cancer which will be responsible for weight gain
d. Franks resting metabolic rate could be decreased due to increasing the thermic
effect of food.
16. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
i. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
j. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
k. Even though excess body fat and excess nutrient intake are evident there still may be
a risk for some type of nutrient deficiency leading to malnutrition.
l. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
17. Which is least likely to be a primary cause of malnutrition?
i. Conditions of poverty
j. Prolonged hospitalization
k. Homelessness
l. Exercise
18. Overnutrition is characterized by
i. overeating at a meal.
j. excess nutrient and energy intake over time.
k. eating a diet with too much variety.
l. using dietary supplements
19. The Dietary Reference Intakes (DRI) address the nutrient needs of
i. all adults.
j. most healthy population groups.
k. minority ethnic groups.
l. pregnant women, infants and children.
20. You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
i. Dietary reference intakes.
j. Dietary Guidelines for Americans.
k. MyPlate food guidance system.
l. Basic four food groups
21. A patient asks you what he should eat to maintain an optimal diet. An appropriate response
would be to
g. eat a variety of foods and eat in moderation.
h. eat only natural, organic foods.
i. use vitamin and mineral supplements to ensure adequate nutrients
22. The goal of the MyPlate food guide is to promote
i. Variety, proportion moderation, gradual improvements, and physical activity.
j. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
k. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
l. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
23. A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast food
restaurants at least twice a week and relies on processed foods for the majority of her dietary
intake. She maintains an active lifestyle and works part time at the local bank. The next
step toassist this woman would be to
g. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
h. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
i. recommend that she use the MyPlate food guide to change her eating style. Assess meal
plan options along with the ability to prepare nutritious foods.
24. The person most at risk for malnutrition would be a(n)
i. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
j. Young child who refuses to eat peas, green beans and broccoli but loves fruits and other
vegetables.
k. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
l. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
25. D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats soup
or a salad and meat along with 2% milk and a sugared soda. He usually has an afternoon
snack of chips and sugared soda and dinner is eaten at a restaurant most days of the week
where he chooses steaks, hamburgers and fries or onion rings along with a salad anda beer
26.
27.
28.
29.
30.
or other high- calorie beverage. One of the most important recommendations for D.C.
would be
i. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
j. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
k. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
l. to enjoy his diet as is but encourage adequate amounts of exercise throughout the week
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how to
control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
i. You will not encourage Vicky to run because it is too risky for her health
j. You will advice Vicky to run but only a small distance (max 20-25minutes)
k. You will encourage Vicky to run only if she will take extra carbs and fat before the run,
sufficient amount of water during the running and after the running extra amount of
protein
l. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 26?
g. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need extra
insulin; if she also has ketosis, she should not run. Before a run, if her blood glucose
level is below 100 mg/dL, she should have a snack before she runs
h. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need extra
insulin. Before a run, if her blood glucose level is below 200 mg/dL, she should have a
snack before she runs
i. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need protein.
Before a run, if her blood glucose level is below 200 mg/dL, she should increase intake
of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
g. Hot chili peppers, black pepper, and chili powder.
h. Mint tea, sugar, apple and banana
i. Potatoes, cucumber and beans
Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
e. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
f. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
Quinn had stomach cancer and had to have most of his stomach removed. He has recovered
quite well and usually manages to eat six small meals a day. Sometimes he experiences
31.
32.
33.
34.
35.
36.
37.
cramps, nausea, sweating, and weakness after he eats. What do you think what could be the
reason for this symptoms and which food Quinn should avoid?
i. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar, alcohol,
or sweet sodas
j. Celiac disease, Quinn should avoid Gluten consisting food
k. Diabetes Mellitus Type I, starting insulin therapy
l. Gastric ulcer. Quinn should avoid caffeine and chocolate
George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
d. George should start parenteral nutrition for 4-8days because weight loss is severe
e. George has no stomach, but the rest of his gut still works, so he should receive
enteral nutrition support. He should be fed via a jejunostomy, below the site of the
gastrectomy. Feedings should be continuous over 12 to 24 hours of each day.
f. There is no Need for enteral nutrition. George should avoid high amount of simple
carbs, sweet food in order to reduce dumping syndrome. He should increase fibers
and protein in his diet
The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
a. HbA1c.
b. serum triglyceride.
c. serum cholesterol.
The development stage for an adult 47 years of age is
a. a very young adult.
b. a young adult.
c. a middle adult.
d. an older adult.
Studies indicate that exercise
a. decreases insulin production.
b. increases conversion of amino acids to glucose.
c. improves uptake of glucose by the cells.
d. causes unpredictable blood glucose levels.
As a person ages, lack of exercise contributes to
a. anemia.
b. labored breathing.
c. loss of skeletal muscle mass.
d. kidney failure.
Dehydration is more common in older adults than in younger adults because
a. they may forget to finish beverages.
b. the thirst mechanism diminishes.
c. fluid may accumulate in the extremities.
d. water losses during respiration are increased.
As people age, total energy needs
a. increase each decade of life after the age of 30 years.
b. slowly decline throughout the aging process.
c. remain the same until the age of 70 years.
38. An example of resistance training is
a. swimming.
b. walking.
c. walking very quickly.
d. lifting weights.
39. The most beneficial rehydration fluid for most types of exercise is
a. commercial sports drinks.
b. diluted juice.
c. full-strength juice.
d. water.
40. It is common for patients with acute kidney failure to need
a. enteral nutrition.
b. calcium supplements.
c. blood transfusions.
d. assistance with feeding.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Version N2
Test consists of 40 questions, each question – 1 point; total-40 points
1. Which of the following is the most accurate statement regarding the functions of protein?
m. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
n. Proteins are a necessary nutrient to provide energy for the body in times of stress.
o. Proteins can be used as coen>yme factors during cell metabolism.
p. Proteins are essential to tissue building and repair within the body
2. The main nutrients involved in metabolic regulation and control are
m. water and vitamins.
n. vitamins and minerals.
o. vitamins and fatty acids.
p. minerals and carbohydrates.
3. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
m. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
n. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
o. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
p. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
4. A young woman is 4 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
m. liver damage.
n. osteopenia.
o. undernutrition.
p. overnutrition.
5. Hich factors place a person at the greatest risk for malnutrition?
m. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
n. poor hygiene insufficient exercise and excess carbohydrate intake
o. depleted carbohydrate intake poor hygiene and excess calorie intake
p. poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
6. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
m. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
n. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
o. Even though excess body fat and excess nutrient intake are evident there still may be
a risk for some type of nutrient deficiency leading to malnutrition.
7.
8.
9.
10.
11.
12.
13.
p. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
Which is least likely to be a primary cause of malnutrition?
m. Conditions of poverty
n. Prolonged hospitalization
o. Homelessness
p. Exercise
Overnutrition is characterized by
m. overeating at a meal.
n. excess nutrient and energy intake over time.
o. eating a diet with too much variety.
p. using dietary supplements
The Dietary Reference Intakes (DRI) address the nutrient needs of
m. all adults.
n. most healthy population groups.
o. minority ethnic groups.
p. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
m. Dietary reference intakes.
n. Dietary Guidelines for Americans.
o. MyPlate food guidance system.
p. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate
response would be to
j. eat a variety of foods and eat in moderation.
k. eat only natural, organic foods.
l. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
m. Variety, proportion moderation, gradual improvements, and physical activity.
n. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
o. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
p. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast
food restaurants at least twice a week and relies on processed foods for the majority of her
dietary intake. She maintains an active lifestyle and works part time at the local bank. The
next step toassist this woman would be to
j. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
14.
15.
16.
17.
k. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
l. recommend that she use the MyPlate food guide to change her eating style. Assess
meal plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
m. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
n. Young child who refuses to eat peas, green beans and broccoli but loves fruits and
other vegetables.
o. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
p. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats
soup or a salad and meat along with 2% milk and a sugared soda. He usually has an
afternoon snack of chips and sugared soda and dinner is eaten at a restaurant most days of
the week where he chooses steaks, hamburgers and fries or onion rings along with a salad
anda beer or other high- calorie beverage. One of the most important recommendations
for D.C. would be
m. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
n. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
o. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
p. to enjoy his diet as is but encourage adequate amounts of exercise throughout the
week
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how
to control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
m. You will not encourage Vicky to run because it is too risky for her health
n. You will advice Vicky to run but only a small distance (max 20-25minutes)
o. You will encourage Vicky to run only if she will take extra carbs and fat before the
run, sufficient amount of water during the running and after the running extra
amount of protein
p. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 16?
j. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need
extra insulin; if she also has ketosis, she should not run. Before a run, if her blood
glucose level is below 100 mg/dL, she should have a snack before she runs
k. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need
extra insulin. Before a run, if her blood glucose level is below 200 mg/dL, she
18.
19.
20.
21.
22.
23.
should have a snack before she runs
l. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need
protein. Before a run, if her blood glucose level is below 200 mg/dL, she should
increase intake of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
j. Hot chili peppers, black pepper, and chili powder.
k. Mint tea, sugar, apple and banana
l. Potatoes, cucumber and beans
Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
g. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
h. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
Quinn had stomach cancer and had to have most of his stomach removed. He has
recovered quite well and usually manages to eat six small meals a day. Sometimes he
experiences cramps, nausea, sweating, and weakness after he eats. What do you think
what could be the reason for this symptoms and which food Quinn should avoid?
m. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar,
alcohol, or sweet sodas
n. Celiac disease, Quinn should avoid Gluten consisting food
o. Diabetes Mellitus Type I, starting insulin therapy
p. Gastric ulcer. Quinn should avoid caffeine and chocolate
George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
g. George should start parenteral nutrition for 4-8days because weight loss is severe
h. George has no stomach, but the rest of his gut still works, so he should receive
enteral nutrition support. He should be fed via a jejunostomy, below the site of
the gastrectomy. Feedings should be continuous over 12 to 24 hours of each day.
i. There is no Need for enteral nutrition. George should avoid high amount of
simple carbs, sweet food in order to reduce dumping syndrome. He should
increase fibers and protein in his diet
The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
d. HbA1c.
e. serum triglyceride.
f. serum cholesterol.
The development stage for an adult 47 years of age is
e. a very young adult.
f. a young adult.
24.
25.
26.
27.
28.
29.
30.
31.
32.
g. a middle adult.
h. an older adult.
Studies indicate that exercise
e. decreases insulin production.
f. increases conversion of amino acids to glucose.
g. improves uptake of glucose by the cells.
h. causes unpredictable blood glucose levels.
As a person ages, lack of exercise contributes to
e. anemia.
f. labored breathing.
g. loss of skeletal muscle mass.
h. kidney failure.
Dehydration is more common in older adults than in younger adults because
e. they may forget to finish beverages.
f. the thirst mechanism diminishes.
g. fluid may accumulate in the extremities.
h. water losses during respiration are increased.
As people age, total energy needs
d. increase each decade of life after the age of 30 years.
e. slowly decline throughout the aging process.
f. remain the same until the age of 70 years.
An example of resistance training is
e. swimming.
f. walking.
g. walking very quickly.
h. lifting weights.
The most beneficial rehydration fluid for most types of exercise is
e. commercial sports drinks.
f. diluted juice.
g. full-strength juice.
h. water.
It is common for patients with acute kidney failure to need
e. enteral nutrition.
f. calcium supplements.
g. blood transfusions.
h. assistance with feeding.
Before surgery patients should
a. eat a high carbohydrate meal to increase glycogen stores.
b. eat a high protein meal to offset protein losses during surgery.
c. consume no foods or liquids for 8 hours to prevent aspiration.
d. consume only liquids so that the stomach empties rapidly.
Medical nutrition therapy for acute glomerulonephritis consists of
a. sodium restriction at the onset of the disease process.
b. adequate calories to maintain metabolic needs.
33.
34.
35.
36.
37.
38.
39.
40.
c. fluid restriction until antibiotic therapy is completed.
An enteral formula composed of simple nutrient components that do not require further
digestion that is readily absorbed is called
a. elemental.
b. blenderized.
c. standard.
The type of diet recommended for a person with a kidney stone depends on
a. the person’s lifestyle.
b. the composition of the stone.
c. the person’s willingness to use drug therapy.
d. the person’s medical history.
The vitamin needed to build connective tissue during the healing process is
a. thiamin.
b. vitamin C.
c. folate.
a. vitamin D.
Total parenteral nutrition formulas provide protein in the form of
a. lipoproteins.
b. fatty acids.
c. amino acids.
d. dipeptides.
One of the most common nutrient deficiencies among surgical patients is
a. calcium.
b. protein.
c. carbohydrate.
d. vitamin K.
The kidney is responsible for stimulating red blood cell production through
a. erythropoietin secretion.
b. gluconeogenesis.
c. renin secretion.
d. vitamin D activation.
The massive edema of nephrotic syndrome is caused by
a. inadequate urine production.
b. large protein losses in the urine.
c. sodium retention by the kidneys.
If the gastrointestinal tract cannot be used to provide nutrition, then
a. parenteral nutrition may be used to supply nutrients.
b. intravenous normal saline is administered.
c. the patient can be kept without food intake for up to 2 weeks.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Version N2
Test consists of 40 questions, each question – 1 point; total-40 points
1. The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
g. HbA1c.
h. serum triglyceride.
i. serum cholesterol.
2. The development stage for an adult 47 years of age is
i. a very young adult.
j. a young adult.
k. a middle adult.
l. an older adult.
3. Studies indicate that exercise
i. decreases insulin production.
j. increases conversion of amino acids to glucose.
k. improves uptake of glucose by the cells.
l. causes unpredictable blood glucose levels.
4. As a person ages, lack of exercise contributes to
i. anemia.
j. labored breathing.
k. loss of skeletal muscle mass.
l. kidney failure.
5. Insulin is produced by the
a. α-cells of the pancreas.
b. β-cells of the pancreas.
c. glomerulus structure of the kidney.
d. pituitary gland.
6. The disorder in which bone mineral density is low and bones become brittle is called
a. osteoporosis.
b. osteomalacia.
c. rickets.
7. A risk factor for developing type 2 diabetes is
a. autoimmune destruction of the β cells of the pancreas.
b. a history of gestational diabetes.
c. a history of nephritis.
d. alcoholism.
8. Dehydration is more common in older adults than in younger adults because
i. they may forget to finish beverages.
j. the thirst mechanism diminishes.
k. fluid may accumulate in the extremities.
l. water losses during respiration are increased.
9. The type of diabetes that always requires treatment with insulin for survival is
a. type 1 diabetes.
b. type 2 diabetes.
c. gestation diabetes.
d. drug-induced diabetes.
10. As people age, total energy needs
g. increase each decade of life after the age of 30 years.
h. slowly decline throughout the aging process.
i. remain the same until the age of 70 years.
11. Persistent hyperglycemia during pregnancy is associated with an increased risk of
a. macrosomia.
b. preeclampsia.
c. diabetes insipidus.
d. phenylketonuria.
12. An example of resistance training is
i. swimming.
j. walking.
k. walking very quickly.
l. lifting weights.
13. The form of insulin that has its peak action between 2 and 4 hours after administration is
the
a. rapid-acting form.
b. short-acting form.
c. intermediate-acting form.
d. long-acting form.
14. The body meets its short-term energy needs by using
a. glycogen.
b. ketones.
c. glycerol.
d. fatty acids.
15. The hormone considered to act in an opposite manner to insulin is
a. glucagon.
b. pancreatin.
c. vitamin D.
d. thyroxine.
16. For the body to maintain a high level of steady exercise,
a. regular energy intake is required.
b. sufficient oxygen must be available to the cells.
c. the body must depend on anaerobic metabolism.
d. some amino acids must be metabolized to provide a steady source of glucose.
17. The three common, long-term complications of diabetes affect cells in the
a. intestines, liver, and pancreas.
b. kidney, eye, and nerve tissue.
c. heart, blood vessels, and lungs.
18.
19.
20.
21.
22.
23.
24.
25.
26.
d. skin, bone marrow, and lymph nodes.
The most beneficial rehydration fluid for most types of exercise is
i. commercial sports drinks.
j. diluted juice.
k. full-strength juice.
l. water.
The primary focus of medical nutrition therapy for diabetes care is to
a. reduce overall fat intake.
b. maintain glycemic control.
c. carefully follow the prescribed diet.
The primary fuel source for exercise is:
a. carbohydrate.
b. fatty acids.
c. protein.
d. oxygen.
It is common for patients with acute kidney failure to need
i. enteral nutrition.
j. calcium supplements.
k. blood transfusions.
l. assistance with feeding.
If a young female athlete experiences a stress fracture, her health care provider may want
to know if she has:
a. amenorrhea.
b. hypertension.
c. a high caffeine intake.
d. dehydration.
A decrease in the activation of vitamin D in kidney disease results in
a. hypercalcemia.
b. osteodystrophy.
c. hyperoxaluria.
d. calcium stone formation.
Blood losses may result in a deficiency of
a. glucose.
b. sodium.
c. iron.
d. vitamin B12.
The absence of urine production, indicating kidney failure, is called
a. hematuria.
b. oliguria.
c. proteinuria.
d. anuria.
Before surgery patients should
e. eat a high carbohydrate meal to increase glycogen stores.
f. eat a high protein meal to offset protein losses during surgery.
g. consume no foods or liquids for 8 hours to prevent aspiration.
27.
28.
29.
30.
31.
32.
33.
34.
35.
h. consume only liquids so that the stomach empties rapidly.
Medical nutrition therapy for acute glomerulonephritis consists of
d. sodium restriction at the onset of the disease process.
e. adequate calories to maintain metabolic needs.
f. fluid restriction until antibiotic therapy is completed.
Classic symptoms of glomerulonephritis include
a. anuria.
b. proteinuria.
c. low blood pressure.
d. bladder infection.
An enteral formula composed of simple nutrient components that do not require further
digestion that is readily absorbed is called
d. elemental.
e. blenderized.
f. standard.
The type of diet recommended for a person with a kidney stone depends on
e. the person’s lifestyle.
f. the composition of the stone.
g. the person’s willingness to use drug therapy.
h. the person’s medical history.
Elevated blood urea nitrogen, serum creatinine, and serum uric acid levels are reflected in
the laboratory finding of
a. metabolic acidosis.
b. azotemia.
c. nephrosis.
The vitamin needed to build connective tissue during the healing process is
d. thiamin.
e. vitamin C.
f. folate.
b. vitamin D.
For patients with chronic kidney failure, potassium intake is based on
a. the presence of edema.
b. serum potassium level.
c. overall fluid balance.
d. blood pressure level.
Total parenteral nutrition formulas provide protein in the form of
e. lipoproteins.
f. fatty acids.
g. amino acids.
h. dipeptides.
Patients with chronic kidney disease often develop anemia due to
a. poor iron absorption.
b. generalized malnutrition.
c. an increased breakdown of hemoglobin.
36.
37.
38.
39.
40.
d. the inadequate production of erythropoietin.
One of the most common nutrient deficiencies among surgical patients is
e. calcium.
f. protein.
g. carbohydrate.
h. vitamin K.
The kidney is responsible for stimulating red blood cell production through
e. erythropoietin secretion.
f. gluconeogenesis.
g. renin secretion.
h. vitamin D activation.
Medical nutrition therapy after a cholecystectomy consists of
a. a high-fiber diet to prevent constipation.
b. a low-fat or moderate-fat diet to reduce gallbladder stimulation.
c. a low-protein diet to decrease stress on the kidneys.
d. increased vitamin E intake to promote wound healing.
The massive edema of nephrotic syndrome is caused by
d. inadequate urine production.
e. large protein losses in the urine.
f. sodium retention by the kidneys.
If the gastrointestinal tract cannot be used to provide nutrition, then
d. parenteral nutrition may be used to supply nutrients.
e. intravenous normal saline is administered.
f. the patient can be kept without food intake for up to 2 weeks.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Version N2
Test consists of 40 questions, each question – 1 point; total-40 points
1. The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
a. HbA1c.
b. serum triglyceride.
c. serum cholesterol.
2. The development stage for an adult 47 years of age is
a. a very young adult.
b. a young adult.
c. a middle adult.
d. an older adult.
3. Studies indicate that exercise
a. decreases insulin production.
b. increases conversion of amino acids to glucose.
c. improves uptake of glucose by the cells.
d. causes unpredictable blood glucose levels.
4. As a person ages, lack of exercise contributes to
a. anemia.
b. labored breathing.
c. loss of skeletal muscle mass.
d. kidney failure.
5. Insulin is produced by the
a. α-cells of the pancreas.
b. β-cells of the pancreas.
c. glomerulus structure of the kidney.
d. pituitary gland.
6. The disorder in which bone mineral density is low and bones become brittle is called
a. osteoporosis.
b. osteomalacia.
c. rickets.
7. A risk factor for developing type 2 diabetes is
a. autoimmune destruction of the β cells of the pancreas.
b. a history of gestational diabetes.
c. a history of nephritis.
d. alcoholism.
8. Dehydration is more common in older adults than in younger adults because
a. they may forget to finish beverages.
b. the thirst mechanism diminishes.
c. fluid may accumulate in the extremities.
d. water losses during respiration are increased.
9. The type of diabetes that always requires treatment with insulin for survival is
a. type 1 diabetes.
b. type 2 diabetes.
c. gestation diabetes.
d. drug-induced diabetes.
10. As people age, total energy needs
a. increase each decade of life after the age of 30 years.
b. slowly decline throughout the aging process.
c. remain the same until the age of 70 years.
11. Persistent hyperglycemia during pregnancy is associated with an increased risk of
a. macrosomia.
b. preeclampsia.
c. diabetes insipidus.
d. phenylketonuria.
12. An example of resistance training is
a. swimming.
b. walking.
c. walking very quickly.
d. lifting weights.
13. The form of insulin that has its peak action between 2 and 4 hours after administration is
the
a. rapid-acting form.
b. short-acting form.
c. intermediate-acting form.
d. long-acting form.
14. The body meets its short-term energy needs by using
a. glycogen.
b. ketones.
c. glycerol.
d. fatty acids.
15. The hormone considered to act in an opposite manner to insulin is
a. glucagon.
b. pancreatin.
c. vitamin D.
d. thyroxine.
16. For the body to maintain a high level of steady exercise,
a. regular energy intake is required.
b. sufficient oxygen must be available to the cells.
c. the body must depend on anaerobic metabolism.
d. some amino acids must be metabolized to provide a steady source of glucose.
17. The three common, long-term complications of diabetes affect cells in the
a. intestines, liver, and pancreas.
b. kidney, eye, and nerve tissue.
c. heart, blood vessels, and lungs.
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d. skin, bone marrow, and lymph nodes.
The most beneficial rehydration fluid for most types of exercise is
a. commercial sports drinks.
b. diluted juice.
c. full-strength juice.
d. water.
The primary focus of medical nutrition therapy for diabetes care is to
a. reduce overall fat intake.
b. maintain glycemic control.
c. carefully follow the prescribed diet.
The primary fuel source for exercise is:
a. carbohydrate.
b. fatty acids.
c. protein.
d. oxygen.
It is common for patients with acute kidney failure to need
a. enteral nutrition.
b. calcium supplements.
c. blood transfusions.
d. assistance with feeding.
If a young female athlete experiences a stress fracture, her health care provider may want
to know if she has:
a. amenorrhea.
b. hypertension.
c. a high caffeine intake.
d. dehydration.
A decrease in the activation of vitamin D in kidney disease results in
a. hypercalcemia.
b. osteodystrophy.
c. hyperoxaluria.
d. calcium stone formation.
Blood losses may result in a deficiency of
a. glucose.
b. sodium.
c. iron.
d. vitamin B12.
The absence of urine production, indicating kidney failure, is called
a. hematuria.
b. oliguria.
c. proteinuria.
d. anuria.
Before surgery patients should
a. eat a high carbohydrate meal to increase glycogen stores.
b. eat a high protein meal to offset protein losses during surgery.
c. consume no foods or liquids for 8 hours to prevent aspiration.
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d. consume only liquids so that the stomach empties rapidly.
Medical nutrition therapy for acute glomerulonephritis consists of
a. sodium restriction at the onset of the disease process.
b. adequate calories to maintain metabolic needs.
c. fluid restriction until antibiotic therapy is completed.
Classic symptoms of glomerulonephritis include
a. anuria.
b. proteinuria.
c. low blood pressure.
d. bladder infection.
An enteral formula composed of simple nutrient components that do not require further
digestion that is readily absorbed is called
a. elemental.
b. blenderized.
c. standard.
The type of diet recommended for a person with a kidney stone depends on
a. the person’s lifestyle.
b. the composition of the stone.
c. the person’s willingness to use drug therapy.
d. the person’s medical history.
Elevated blood urea nitrogen, serum creatinine, and serum uric acid levels are reflected in
the laboratory finding of
a. metabolic acidosis.
b. azotemia.
c. nephrosis.
The vitamin needed to build connective tissue during the healing process is
a. thiamin.
b. vitamin C.
c. folate.
a. vitamin D.
For patients with chronic kidney failure, potassium intake is based on
a. the presence of edema.
b. serum potassium level.
c. overall fluid balance.
d. blood pressure level.
Total parenteral nutrition formulas provide protein in the form of
a. lipoproteins.
b. fatty acids.
c. amino acids.
d. dipeptides.
Patients with chronic kidney disease often develop anemia due to
a. poor iron absorption.
b. generalized malnutrition.
c. an increased breakdown of hemoglobin.
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d. the inadequate production of erythropoietin.
One of the most common nutrient deficiencies among surgical patients is
a. calcium.
b. protein.
c. carbohydrate.
d. vitamin K.
The kidney is responsible for stimulating red blood cell production through
a. erythropoietin secretion.
b. gluconeogenesis.
c. renin secretion.
d. vitamin D activation.
Medical nutrition therapy after a cholecystectomy consists of
a. a high-fiber diet to prevent constipation.
b. a low-fat or moderate-fat diet to reduce gallbladder stimulation.
c. a low-protein diet to decrease stress on the kidneys.
d. increased vitamin E intake to promote wound healing.
The massive edema of nephrotic syndrome is caused by
a. inadequate urine production.
b. large protein losses in the urine.
c. sodium retention by the kidneys.
If the gastrointestinal tract cannot be used to provide nutrition, then
a. parenteral nutrition may be used to supply nutrients.
b. intravenous normal saline is administered.
c. the patient can be kept without food intake for up to 2 weeks.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Version N2
Test consists of 40 questions, each question – 1 point; total-40 points
1. Which of the following is the most accurate statement regarding the functions of protein?
a. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
b. Proteins are a necessary nutrient to provide energy for the body in times of stress.
c. Proteins can be used as coen>yme factors during cell metabolism.
d. Proteins are essential to tissue building and repair within the body
2. The main nutrients involved in metabolic regulation and control are
a. water and vitamins.
b. vitamins and minerals.
c. vitamins and fatty acids.
d. minerals and carbohydrates.
3. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
a. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
b. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
c. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
d. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
4. A young woman is 4 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
a. liver damage.
b. osteopenia.
c. undernutrition.
d. overnutrition.
5. Hich factors place a person at the greatest risk for malnutrition?
a. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
b. poor hygiene insufficient exercise and excess carbohydrate intake
c. depleted carbohydrate intake poor hygiene and excess calorie intake
d. poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
6. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
a. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
b. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
c. Even though excess body fat and excess nutrient intake are evident there still may be a
risk for some type of nutrient deficiency leading to malnutrition.
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d. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
Which is least likely to be a primary cause of malnutrition?
a. Conditions of poverty
b. Prolonged hospitalization
c. Homelessness
d. Exercise
Overnutrition is characterized by
a. overeating at a meal.
b. excess nutrient and energy intake over time.
c. eating a diet with too much variety.
d. using dietary supplements
The Dietary Reference Intakes (DRI) address the nutrient needs of
a. all adults.
b. most healthy population groups.
c. minority ethnic groups.
d. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
a. Dietary reference intakes.
b. Dietary Guidelines for Americans.
c. MyPlate food guidance system.
d. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate
response would be to
a. eat a variety of foods and eat in moderation.
b. eat only natural, organic foods.
c. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
a. Variety, proportion moderation, gradual improvements, and physical activity.
b. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
c. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
d. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast
food restaurants at least twice a week and relies on processed foods for the majority of her
dietary intake. She maintains an active lifestyle and works part time at the local bank. The
next step toassist this woman would be to
a. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
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b. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
c. recommend that she use the MyPlate food guide to change her eating style. Assess meal
plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
a. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
b. Young child who refuses to eat peas, green beans and broccoli but loves fruits and
other vegetables.
c. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
d. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats
soup or a salad and meat along with 2% milk and a sugared soda. He usually has an
afternoon snack of chips and sugared soda and dinner is eaten at a restaurant most days of
the week where he chooses steaks, hamburgers and fries or onion rings along with a salad
anda beer or other high- calorie beverage. One of the most important recommendations
for D.C. would be
a. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
b. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
c. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the
week
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how
to control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
a. You will not encourage Vicky to run because it is too risky for her health
b. You will advice Vicky to run but only a small distance (max 20-25minutes)
c. You will encourage Vicky to run only if she will take extra carbs and fat before the
run, sufficient amount of water during the running and after the running extra
amount of protein
d. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 16?
a. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need
extra insulin; if she also has ketosis, she should not run. Before a run, if her blood
glucose level is below 100 mg/dL, she should have a snack before she runs
b. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need
extra insulin. Before a run, if her blood glucose level is below 200 mg/dL, she
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should have a snack before she runs
c. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need
protein. Before a run, if her blood glucose level is below 200 mg/dL, she should
increase intake of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
a. Hot chili peppers, black pepper, and chili powder.
b. Mint tea, sugar, apple and banana
c. Potatoes, cucumber and beans
Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
a. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
b. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
Quinn had stomach cancer and had to have most of his stomach removed. He has
recovered quite well and usually manages to eat six small meals a day. Sometimes he
experiences cramps, nausea, sweating, and weakness after he eats. What do you think
what could be the reason for this symptoms and which food Quinn should avoid?
a. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar,
alcohol, or sweet sodas
b. Celiac disease, Quinn should avoid Gluten consisting food
c. Diabetes Mellitus Type I, starting insulin therapy
d. Gastric ulcer. Quinn should avoid caffeine and chocolate
George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
a. George should start parenteral nutrition for 4-8days because weight loss is severe
b. George has no stomach, but the rest of his gut still works, so he should receive
enteral nutrition support. He should be fed via a jejunostomy, below the site of the
gastrectomy. Feedings should be continuous over 12 to 24 hours of each day.
c. There is no Need for enteral nutrition. George should avoid high amount of
simple carbs, sweet food in order to reduce dumping syndrome. He should
increase fibers and protein in his diet
The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
a. HbA1c.
b. serum triglyceride.
c. serum cholesterol.
The development stage for an adult 47 years of age is
a. a very young adult.
b. a young adult.
24.
25.
26.
27.
28.
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30.
31.
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c. a middle adult.
d. an older adult.
Studies indicate that exercise
a. decreases insulin production.
b. increases conversion of amino acids to glucose.
c. improves uptake of glucose by the cells.
d. causes unpredictable blood glucose levels.
As a person ages, lack of exercise contributes to
a. anemia.
b. labored breathing.
c. loss of skeletal muscle mass.
d. kidney failure.
Dehydration is more common in older adults than in younger adults because
a. they may forget to finish beverages.
b. the thirst mechanism diminishes.
c. fluid may accumulate in the extremities.
d. water losses during respiration are increased.
As people age, total energy needs
a. increase each decade of life after the age of 30 years.
b. slowly decline throughout the aging process.
c. remain the same until the age of 70 years.
An example of resistance training is
a. swimming.
b. walking.
c. walking very quickly.
d. lifting weights.
The most beneficial rehydration fluid for most types of exercise is
a. commercial sports drinks.
b. diluted juice.
c. full-strength juice.
d. water.
It is common for patients with acute kidney failure to need
a. enteral nutrition.
b. calcium supplements.
c. blood transfusions.
d. assistance with feeding.
Before surgery patients should
a. eat a high carbohydrate meal to increase glycogen stores.
b. eat a high protein meal to offset protein losses during surgery.
c. consume no foods or liquids for 8 hours to prevent aspiration.
d. consume only liquids so that the stomach empties rapidly.
Medical nutrition therapy for acute glomerulonephritis consists of
a. sodium restriction at the onset of the disease process.
b. adequate calories to maintain metabolic needs.
33.
34.
35.
36.
37.
38.
39.
40.
c. fluid restriction until antibiotic therapy is completed.
An enteral formula composed of simple nutrient components that do not require further
digestion that is readily absorbed is called
a. elemental.
b. blenderized.
c. standard.
The type of diet recommended for a person with a kidney stone depends on
a. the person’s lifestyle.
b. the composition of the stone.
c. the person’s willingness to use drug therapy.
d. the person’s medical history.
The vitamin needed to build connective tissue during the healing process is
a. thiamin.
b. vitamin C.
c. folate.
a. vitamin D.
Total parenteral nutrition formulas provide protein in the form of
a. lipoproteins.
b. fatty acids.
c. amino acids.
d. dipeptides.
One of the most common nutrient deficiencies among surgical patients is
a. calcium.
b. protein.
c. carbohydrate.
d. vitamin K.
The kidney is responsible for stimulating red blood cell production through
a. erythropoietin secretion.
b. gluconeogenesis.
c. renin secretion.
d. vitamin D activation.
The massive edema of nephrotic syndrome is caused by
a. inadequate urine production.
b. large protein losses in the urine.
c. sodium retention by the kidneys.
If the gastrointestinal tract cannot be used to provide nutrition, then
a. parenteral nutrition may be used to supply nutrients.
b. intravenous normal saline is administered.
c. the patient can be kept without food intake for up to 2 weeks.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Test consists of 40 questions, each question – 1 point; total-40 points
1. Adequate maternal folate intake around the time of conception helps prevent
a. growth retardation.
b. fetal anemia.
c. neural tube defects.
d. maternal hypertension
2. George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
a. George should start parenteral nutrition for 4-8days because weight loss is severe
b. George has no stomach, but the rest of his gut still works, so he should receive enteral
nutrition support. He should be fed via a jejunostomy, below the site of the
gastrectomy. Feedings should be continuous over 12 to 24 hours of each day.
c. There is no Need for enteral nutrition. George should avoid high amount of simple
carbs, sweet food in order to reduce dumping syndrome. He should increase fibers and
protein in his diet
3. The amount of energy required by the body for maintenance of life when a person is at
complete digestive, physical, and emotional rest is referred to as
a. the recommended dietary intake.
b. the estimated energy expenditure.
c. the daily energy requirement.
d. the basal energy expenditure.
4. Adam is a healthy 12-year-old.. Adam quit football. On school days he takes the bus
home from school and usually plays video games and watches television until his
parents come home. By the end of the day, his parents are so tired and hungry that
they often pick up fast food on the way home or put a frozen pizza in the oven.
Adam’s weight is in the overweight range for his height. Do the Adam’s overweight
status affect his health risks?
a. Adam has a higher risk for type 2 diabetes and metabolic syndrome.
b. Adam has a higher risk for CKD and pancreatic dysfunction
c. Adam has a higher risk for type 1 diabetes and neuropathy
5. Which kind of recommendation you would suggest Adam and his parents from
question 4?
a. Adam just needs to increase the activity (start playing football) no need to
change the nutrition
b. Adam needs to increase his activity level and decrease his energy intake. He
needs to focus on developing healthy habits
c. Adam should only decrease amount of fat and increase amount of fiber in food,
and ask to visit you after 6 month to see the results
6. Sarah has had stomach pain she has been diagnosed with a duodenal ulcer and given a
prescription for an antibiotic. She also has been told to take famotidine (Pepcid) daily
and to use antacids as needed when she has stomach pain. Which food Sarah should
avoid?
a. Sarah should avoid very hot and very cold food, ice cream, milk products and
fibers
b. Sarah should avoid hot chili peppers, black pepper, and chili powder. She
may find it helpful to avoid caffeine, chocolate, and alcohol
c. Sarah should avoid alcohol and carb rich food
7. Nutrients are
a. chemical elements or compounds in foods that have specific metabolic
functions within the body.
b. whole foods that are necessary for good health.
c. exclusively energy-yielding compounds.
d. nourishing foods used to cure certain illnesses
8. All nutrients needed by the body
a. must be obtained by specific food combinations.
b. must be obtained by vitamin or mineral supplements.
c. have only one function and use in the body.
d. are supplied by a variety of foods in many different combinations.
9. In the following family of four, who has the highest energy needs per unit of body
weight?
a. 32-year-old mother
b. 35-year-old father
c. 2-month-old son
d. 70-year-old grandmother
10. Frank is 65 years old and is retiring from his teaching job. He has gained weight
gradually up to 8 kg but he does not think he has changed his eating habits or
exercise routine. Why would Frank have gradually gained weight if his food intake
and activity level have not changed?
a. Resting metabolic rate decreases as part of the normal aging process because
muscle mass and basal metabolic rate both gradually decrease with age.
b. Frank can have ulcerative colitis which could lead to malnutrition
c. Frank can have dumping syndrome - body uses less energy than he used to for
the same activities.
11. Which test you will order for Frank from question 10?
a. Measuring blood levels of the hormone testosterone
b. Measuring blood levels of the hormone thyroxine
c. Measuring blood levels of the Iron
12. The increase in metabolic rate after a meal is called
a. satiety.
b. the metabolic stimulus.
c. the thermic effect of food.
d. the postmeal effect.
13. Malnutrition often is caused by
a. acute illness.
b. skipping meals.
c. regular exercise.
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d. prolonged hospitalization.
While performing a nutritional assessment of a low-income family to nurse determines
that the family’s diet is inadequate in protein content. You suggests which of the
following foods to increase protein content?
a. Oranges and potatoes
b. Potatoes and rice
c. Rice and macaroni
d. Peas and beans
A new mother is breast-feeding her infant and asks the nurse about the introduction of
cereals into the diet. Your best response is:
a. "Be sure to test the temperature of the cereal if you use your microwave, as it is easy to
get it too hot. "
b. "You can begin feeding iron-fortified cereals between 4 and 6 months. "
c. "Integrate feeding vegetables and fruit with your cereals at about 1.5-2 months of age’’
A school nurse suspects that one of the junior high students may have anorexia nervosa.
This eating disorder is characterized by:
a. A lack of control over eating patterns
b. Self-imposed starvation
c. Binge-purge cycles
d. Excessive exercise
A patient is pregnant for the third time. In regard to her nutritional status, she should:
a. Limit her weight gain to a maximum of 4 kg
b. Approximately double her protein intake
c. Increase her vitamin A and milk product consumption
d. Increase her intake of folic acid
Which of the following foods is a complete protein?
a. Eggs
b. Oats
c. Lentils
d. Peanuts
Pregnant teens who have a low weight gain by 20 weeks’ gestation may be at most risk for
a. gestational diabetes.
b. intrauterine growth failure.
c. a neural tube defect in the baby.
d. bone fractures.
Which of the following is the most accurate statement regarding the functions of protein?
a. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
b. Proteins are a necessary nutrient to provide energy for the body in times of stress.
c. Proteins can be used as coen>yme factors during cell metabolism.
d. Proteins are essential to tissue building and repair within the body
The main nutrients involved in metabolic regulation and control are
a. water and vitamins.
b. vitamins and minerals.
c. vitamins and fatty acids.
d. minerals and carbohydrates.
22. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
a. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
b. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
c. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
d. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
23. A young woman is 5 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
a. liver damage.
b. osteopenia.
c. undernutrition.
d. overnutrition.
24. Hich factors place a person at the greatest risk for malnutrition?
a. poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
b. poor hygiene insufficient exercise and excess carbohydrate intake
c. depleted carbohydrate intake poor hygiene and excess calorie intake
d. poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
25. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
a. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
b. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
c. Even though excess body fat and excess nutrient intake are evident there still may be a
risk for some type of nutrient deficiency leading to malnutrition.
d. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
26. Which is least likely to be a primary cause of malnutrition?
a. Conditions of poverty
b. Prolonged hospitalization
c. Homelessness
d. Exercise
27. Overnutrition is characterized by
a. overeating at a meal.
b. excess nutrient and energy intake over time.
c. eating a diet with too much variety.
d. using dietary supplements
28. The Dietary Reference Intakes (DRI) address the nutrient needs of
a. all adults.
29.
30.
31.
32.
33.
34.
b. most healthy population groups.
c. minority ethnic groups.
d. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
a. Dietary reference intakes.
b. Dietary Guidelines for Americans.
c. MyPlate food guidance system.
d. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate
response would be to
a. eat a variety of foods and eat in moderation.
b. eat only natural, organic foods.
c. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
a. Variety, proportion moderation, gradual improvements, and physical activity.
b. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
c. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
d. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast
food restaurants at least twice a week and relies on processed foods for the majority of her
dietary intake. She maintains an active lifestyle and works part time at the local bank. The
next step toassist this woman would be to
a. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
b. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
c. recommend that she use the MyPlate food guide to change her eating style. Assess meal
plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
a. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
b. Young child who refuses to eat peas, green beans and broccoli but loves fruits and
other vegetables.
c. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
d. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats
35.
36.
37.
38.
soup or a salad and meat along with 2% milk and a sugared soda. He usually has an
afternoon snack of chips and sugared soda and dinner is eaten at a restaurant most days of
the week where he chooses steaks, hamburgers and fries or onion rings along with a salad
anda beer or other high- calorie beverage. One of the most important recommendations
for D.C. would be
a. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
b. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
c. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the
week
Medical nutrition therapy for congestive heart failure usually includes
a. increased fluid intake.
b. decreased protein intake.
c. sodium restriction.
d. potassium restriction.
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how
to control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
a. You will not encourage Vicky to run because it is too risky for her health
b. You will advice Vicky to run but only a small distance (max 20-25minutes)
c. You will encourage Vicky to run only if she will take extra carbs and fat before the
run, sufficient amount of water during the running and after the running extra
amount of protein
d. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 36?
a. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need extra
insulin; if she also has ketosis, she should not run. Before a run, if her blood glucose
level is below 100 mg/dL, she should have a snack before she runs
b. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need extra
insulin. Before a run, if her blood glucose level is below 200 mg/dL, she should have a
snack before she runs
c. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need
protein. Before a run, if her blood glucose level is below 200 mg/dL, she should
increase intake of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
a. Hot chili peppers, black pepper, and chili powder.
b. Mint tea, sugar, apple and banana
c. Potatoes, cucumber and beans
39. Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
a. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
b. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
40. Quinn had stomach cancer and had to have most of his stomach removed. He has
recovered quite well and usually manages to eat six small meals a day. Sometimes he
experiences cramps, nausea, sweating, and weakness after he eats. What do you think
what could be the reason for this symptoms and which food Quinn should avoid?
a. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar, alcohol,
or sweet sodas
b. Celiac disease, Quinn should avoid Gluten consisting food
c. Diabetes Mellitus Type I, starting insulin therapy
d. Gastric ulcer. Quinn should avoid caffeine and chocolate
1. In type 1 diabetes, blood glucose levels are high because:
a. urinary excretion of glucose is impaired.
b. lean body mass is metabolized to produce glucose via gluconeogenesis.
c. absorption of glucose from the gastrointestinal tract is more efficient.
d. there is insufficient insulin to facilitate transport of glucose into the cells.
2. A condition that often progresses to become type 2 diabetes is:
a. type 1 diabetes.
b. high blood pressure.
c. chronic pancreatitis.
d. impaired glucose tolerance.
3. Clients with type 2 diabetes are most likely to achieve metabolic control if they:
a. lose weight.
b. use insulin therapy.
c. eliminate all dietary sugars.
d. eat three regular meals daily.
4. Nutrition therapy for clients with diabetes is based on:
a. low dietary intake of sugars.
b. standardized diabetic diet plans.
c. each client’s lifestyle and preferences.
d. the client’s weight and blood glucose level.
5. Major complications of diabetes include damage to the:
a. stomach, liver, and pancreas.
b. eyes, nerves, and kidneys.
c. skin, blood vessels, and lungs.
d. brain, pituitary gland, and thyroid gland.
6. The type of islet cell in the pancreas that synthesizes insulin is:
a. alpha cells.
b. beta cells.
c. gamma cells.
d. delta cells.
7. Metabolic control is especially important for women with gestational diabetes to ensure
the infant does not develop:
a. microsomia.
b. macrosomia.
c. type 1 diabetes.
d. type 2 diabetes.
8. Symptoms of uncontrolled type 1 diabetes include:
a. depression, anxiety, and fatigue.
b. increased thirst, urination, and hunger.
c. weight gain, macrosomia, and food cravings.
d. poor wound healing, blurred vision, and recurrent infections.
9. A test used to monitor the degree of blood glucose control over a long period is:
a. glucose tolerance test.
b. glycated hemoglobin level.
10.
11.
12.
13.
14.
15.
16.
17.
18.
c. self-monitoring of blood glucose.
d. 24-hour urinary glucose excretion.
Causes of acute renal failure include:
a. chronic renal failure.
b. uncontrolled diabetes mellitus.
c. severe injury such as extensive burns.
One factor that contributes to development of bone diseases in patients with CKD is
retention of:
a. iron.
b. sodium.
c. potassium.
d. phosphorus.
The mechanism behind most CKD in patients without diabetes is mediated by:
a. enzyme systems.
b. immune systems.
c. catabolic systems.
d. hormonal systems.
The most common type of kidney stones is:
a. cystine.
b. calcium.
c. struvite.
d. uric acid.
A common comorbidity in patients with CKD is:
a. liver disease.
b. malnutrition.
c. acute renal failure.
d. difficulty breathing.
The initial major sign of acute renal failure is:
a. oliguria.
b. hematuria.
c. proteinuria.
d. glycosuria.
Patients with kidney stones should increase their intake of:
a. fluids.
b. vitamin C.
c. acid-ash foods.
d. alkaline-ash foods.
Clients with Stage 5 CKD disease have a glomerular filtration rate less than:
a. 15 mL/min/1.73 m2.
b. 35 mL/min/1.73 m2.
c. 85 mL/min/1.73 m2.
d. 125 mL/min/1.73 m2.
The MyPyramid Food Guidance System gives specific food plans for each:
a. socioeconomic group.
b. ethnic and religious group.
c. age, gender, and activity level.
d. level of nutritional status.
19. The amount of energy used for internal chemical activities of all the cells and vital organs
is called:
a. thermic effect of food.
b. nonshivering thermogenesis.
c. basal metabolic rate.
d. indirect calorimetry.
20. If a client is using medication to help him or her lose weight, the client's diet should be:
a. a well-balanced, low-calorie diet.
b. unrestricted.
c. low in fat.
d. high in fiber and low in simple sugars.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Test consists of 40 questions, each question – 1 point; total-40 points
1. Troy is 54 and works as an insurance adjuster, which means he sits all day. Over the
past 10 years, he has gradually gained weight and is now about 18kg overweight. In
the past few weeks he has been experiencing severe pain after eating, especially if he
eats fried or rich foods. What is the most likely cause of Troy’s pain?
a. Troy probably has ulcerative colitis, pain would be caused by the ulcers in
colon.
b. Troy probably has gallbladder disease. The pain would be caused by
inflammation of the gallbladder (cholecystitis) or gall stones (cholelithiasis)
c. Troy probably has celiac disease, pain would be caused by the inflammation in
the small intestine.
2. What nutritional recommendations would you make to Troy form question 1?
a. Troy should reduce his fat intake. This would help him lose weight and would
reduce contraction of the gallbladder via the cholecystokinin mechanism
b. Troy should exclude protein gluten from his diet, this will reduce the inflammation in
intestines and help the normal absorption
c. Troy should avoid spice and hot food from his diet which will reduce the formation of
ulcers in the colon
3. Nick had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost
about 5kg since the surgery. Which kind of nutrition support Nick needs?
a. He should receive parenteral nutrition support by the central venous access
after 1 week it should be changed by parenteral nutrition support by the
peripheral venous access
b. He should receive enteral nutrition support. He should be fed via a
jejunostomy, below the site of the gastrectomy.
4. Which of the following is the most accurate statement regarding the functions of protein?
a. Proteins can be a primary fuel source even if there is ade3uate carbohydrate inta8e.
b. Proteins are a necessary nutrient to provide energy for the body in times of stress.
c. Proteins can be used as coen>yme factors during cell metabolism.
d. Proteins are essential to tissue building and repair within the body
5. The main nutrients involved in metabolic regulation and control are
a. water and vitamins.
b. vitamins and minerals.
c. vitamins and fatty acids.
d. minerals and carbohydrates.
6. The dietary regimen that would provide optimal nutrition for a person who is recovering
from an extended illness is a diet
a. low in protein, fat, and carbohydrates; high in minerals and vitamins; and very low in
fiber.
b. providing adequate amounts of carbohydrates protein, fat, minerals, and vitamins
along with adequate water and fiber.
c. high in protein fiber and fluid; low in carbohydrates; and adequate in vitamins
andminerals.
d. with essential amounts of vitamins and minerals; high in protein; and low in fat
carbohydrates and fibers
7. Sonja has severe ulcerative colitis. She is able to eat small amounts, but severe
diarrhea prevents her from eating enough to maintain a healthy weight and nutritional
status
a. Sonja will need parenteral nutrition support because she cannot absorb
sufficient nutrients because of the ulcerative colitis. She will probably need a
central line, because she is likely to need parenteral nutrition for longer than
14 days.
b. Sonja needs enteral nutrition gastrostomy for 2-3 days, after that she should avoid
irritating foods such as hot chili peppers, black pepper, and chili powder. She may
find it helpful to avoid caffeine, chocolate, and alcohol
8. Health problems that have been shown to be related to obesity include
a. Kidney disease and heart disease.
b. Heart disease and diabetes.
c. Diabetes and anemia.
d. Anemia and arthritis.
9. A young woman is 4 months pregnant. She currently lives in a condition of poverty and
often runs out of money to buy food. She is most at risk for
a. Liver damage.
b. Osteopenia.
c. Undernutrition.
d. Overnutrition.
10. Jane is approximately 8 weeks pregnant. She felt good at first, but for the last 2 weeks
she has had mild nausea throughout the day. She has not had much appetite and has
lost a few pounds. She knows she should probably eat more, but she is finding eating
to be difficult. What would you suggest to help Jane eat more?
a. Jane should eat small, frequent meals, with a small meal or snack
approximately every 2 hours. She also could try drinking liquids between
meals rather than with meals.
b. Jane needs a supply of high-carbohydrate and fat and modarate-protein snacks.
She needs to increase amount of fibers and in her diet.
11. Sports drinks or other electrolyte replacement aids:
a. Should not be necessary unless the event lasts longer than 1 hour. For events
lasting 1+ hours, beverages containing 6% - 8% glucose concentrations are
recommended.
b. They are not necessary unless the event last longer than 2 hours. For events lasting
2+ hours, beverages containing 20% - 25% glucose concentrations are
recommended.
12. An overactive thyroid causes
a. Decreased energy need.
b. No effect on energy need.
c. Increased energy need.
d. Decreased protein need.
13. Hich factors place a person at the greatest risk for malnutrition?
a.
b.
c.
d.
poor appetite insufficient nutrient intake poor hygiene and depleted nutrition reserves
poor hygiene insufficient exercise and excess carbohydrate intake
depleted carbohydrate intake poor hygiene and excess calorie intake
poor appetite insufficient nutrient intake depleted nutrition reserves and a form of
metabolic stress
14. An eating disorder characterized by gorging on food and then inducing vomiting is
a. anorexia nervosa.
b. bulimia nervosa.
c. hyperemesis.
d. binge eating disorder.
15. Frank is 65 years old. He always gains a few pounds during the school year and loses
them again during the summer, when he is able to be more active. During the last few
years he has gained a few more pounds than he has lost and is now approximately 7kg
heavier than his ideal body weight. He does not think he has changed his eating habits
or exercise routine, so he is surprised that he has gradually gained weight.
a. Franks weight gain can be explained by having metabolic syndrome and
diabetes mellitus type 2.
b. Franks resting metabolic rate decreases as part of the normal aging process
because muscle mass and basal metabolic rate both gradually decrease with
age
c. Frank can have stomach cancer which will be responsible for weight gain
d. Franks resting metabolic rate could be decreased due to increasing the thermic
effect of food.
16. Mr. Katz who is 48 years old is admitted to the hospital with a fracture to his left hip. He
weighs 113kg (25kg above his desired weight). He is considered to be in a state of
overnutrition. The statement most true regarding his state of overnutrition is
a. Desired nutrients are consumed in excess amounts without the risk of malnutrition.
b. Because excess body fat is evident and excess calories are consumed there is no risk of
nutrient deficiency leading to malnutrition.
c. Even though excess body fat and excess nutrient intake are evident there still may be a
risk for some type of nutrient deficiency leading to malnutrition.
d. Excess body weight may or may not be present along with excess consumption of
carbohydrates and fat which results in inadequate vitamin and mineral intake.
17. Which is least likely to be a primary cause of malnutrition?
a. Conditions of poverty
b. Prolonged hospitalization
c. Homelessness
d. Exercise
18. Overnutrition is characterized by
a. overeating at a meal.
b. excess nutrient and energy intake over time.
c. eating a diet with too much variety.
d. using dietary supplements
19. The Dietary Reference Intakes (DRI) address the nutrient needs of
a. all adults.
20.
21.
22.
23.
24.
25.
b. most healthy population groups.
c. minority ethnic groups.
d. pregnant women, infants and children.
You are asked to help plan meals for a local monthly community dinner meeting for the
elderly. The tool that would be most helpful for planning healthy meals is the
a. Dietary reference intakes.
b. Dietary Guidelines for Americans.
c. MyPlate food guidance system.
d. Basic four food groups
A patient asks you what he should eat to maintain an optimal diet. An appropriate
response would be to
a. eat a variety of foods and eat in moderation.
b. eat only natural, organic foods.
c. use vitamin and mineral supplements to ensure adequate nutrients
The goal of the MyPlate food guide is to promote
a. Variety, proportion moderation, gradual improvements, and physical activity.
b. Physical activity, portion control, daily blood pressure monitoring, and gradual
improvements in health.
c. Portion control, daily physical activity, daily glucose monitoring, moderation, and
variety.
d. Variety, moderation, weighing food portions, daily blood pressure monitoring, and
glucose monitoring.
A 52 years old single woman comes to the health professional for advice on maintaining
optimal nutritional health. Her food intake records indicate that she likes to eat at fast
food restaurants at least twice a week and relies on processed foods for the majority of her
dietary intake. She maintains an active lifestyle and works part time at the local bank. The
next step toassist this woman would be to
a. obtain laboratory values to further assess her nutrition status and recommend
supplementing her diet with vitamins and minerals.
b. find ways to decrease eating at fast food restaurants and incorporate physical e4ercise
into her daily routine.
c. recommend that she use the MyPlate food guide to change her eating style. Assess meal
plan options along with the ability to prepare nutritious foods.
The person most at risk for malnutrition would be a(n)
a. Active young adult who eats 3 to 7 servings of fruits and vegetables along with lean
meats and fish and complex carbohydrates and exercises 3 times a week.
b. Young child who refuses to eat peas, green beans and broccoli but loves fruits and
other vegetables.
c. Middle aged man undergoing chemotherapy for leukemia and who is having difficulty
eating solid food.
d. Young weight lifter who has recently undergone surgery for a compound fracture of
his left femur
D.C is a 45 years old man who has a history of diabetes and the dietary history reveals that
he enjoys a good breakfast with whole grain cereal and fruit. For lunch he usually eats
26.
27.
28.
29.
soup or a salad and meat along with 2% milk and a sugared soda. He usually has an
afternoon snack of chips and sugared soda and dinner is eaten at a restaurant most days of
the week where he chooses steaks, hamburgers and fries or onion rings along with a salad
anda beer or other high- calorie beverage. One of the most important recommendations
for D.C. would be
a. not to eat at restaurants on a regular basis unless he chooses salads only along with
water.
b. to continue with whole grains, lean proteins and vegetables and replace sugary sodas
with sugar free beverages.
c. to drink milk and eliminate soups replacing them with fatty fish five meals a week.
d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the
week
Vicky is 15 years old and has been diagnosed with type 1 diabetes. She understands how
to control her blood glucose level by using three insulin injections a day and counting
carbohydrates. She checks her blood glucose level several times a day. Cross-country
running season is just about to start. She has always loved to run and wants to patricipate.
Your recommendations:
a. You will not encourage Vicky to run because it is too risky for her health
b. You will advice Vicky to run but only a small distance (max 20-25minutes)
c. You will encourage Vicky to run only if she will take extra carbs and fat before the
run, sufficient amount of water during the running and after the running extra
amount of protein
d. You will encourage Vicky to run but she should check her blood glucose level before
and after each training run. She should learn to adjust her insulin and food intake so
that her blood glucose level stays within normal limits before and after exercise
What could be the notable Blood glucose levels for Vicky according from Question 26?
a. Before a run, if her blood glucose level is greater than 250 mg/dL, she may need extra
insulin; if she also has ketosis, she should not run. Before a run, if her blood glucose
level is below 100 mg/dL, she should have a snack before she runs
b. Before a run, if her blood glucose level is greater than 110 mg/dL, she may need extra
insulin. Before a run, if her blood glucose level is below 200 mg/dL, she should have a
snack before she runs
c. Before a run, if her blood glucose level is greater than 400 mg/dL, she may need
protein. Before a run, if her blood glucose level is below 200 mg/dL, she should
increase intake of water.
Sarah has been diagnosed with a duodenal ulcer and given a prescription for an antibiotic.
She also has been told to take antacids as needed when she has stomach pain; Sarah should
simply avoid any foods that cause pain.wich food should Sarah avoid
a. Hot chili peppers, black pepper, and chili powder.
b. Mint tea, sugar, apple and banana
c. Potatoes, cucumber and beans
Will underwent an emergency appendectomy 3 days ago. He is now recovering at home
and has been told he can eat normally. He has not been eating much because he has very
little appetite. Hes BMI is 29.7 and thinks he can use this opportunity to lose some weight.
What would you recommend to Will
a. This is not a good time for Will to try to lose weight. He needs a supply of nutrients
from foods to help his body recover
30.
31.
32.
33.
34.
35.
36.
b. This Good time for weight reduction to reduce kilograms. He has excessive amount of
fat which will be sufficient for his energy requirements
Quinn had stomach cancer and had to have most of his stomach removed. He has
recovered quite well and usually manages to eat six small meals a day. Sometimes he
experiences cramps, nausea, sweating, and weakness after he eats. What do you think
what could be the reason for this symptoms and which food Quinn should avoid?
a. Dumping Syndrome, Quinn should eat very small portions, No milk, sugar,
alcohol, or sweet sodas
b. Celiac disease, Quinn should avoid Gluten consisting food
c. Diabetes Mellitus Type I, starting insulin therapy
d. Gastric ulcer. Quinn should avoid caffeine and chocolate
George had gastric cancer and underwent a total gastrectomy. Four weeks later, he still
experiences severe symptoms of dumping syndrome every time he eats. He has lost about
5kg since the surgery. He has been told he will probably need nutrition support. How you
should help him?
a. George should start parenteral nutrition for 4-8days because weight loss is severe
b. George has no stomach, but the rest of his gut still works, so he should receive
enteral nutrition support. He should be fed via a jejunostomy, below the site of the
gastrectomy. Feedings should be continuous over 12 to 24 hours of each day.
c. There is no Need for enteral nutrition. George should avoid high amount of
simple carbs, sweet food in order to reduce dumping syndrome. He should
increase fibers and protein in his diet
The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
a. HbA1c.
b. serum triglyceride.
c. serum cholesterol.
The development stage for an adult 47 years of age is
a. a very young adult.
b. a young adult.
c. a middle adult.
d. an older adult.
Studies indicate that exercise
a. decreases insulin production.
b. increases conversion of amino acids to glucose.
c. improves uptake of glucose by the cells.
d. causes unpredictable blood glucose levels.
As a person ages, lack of exercise contributes to
a. anemia.
b. labored breathing.
c. loss of skeletal muscle mass.
d. kidney failure.
Dehydration is more common in older adults than in younger adults because
a. they may forget to finish beverages.
37.
38.
39.
40.
b. the thirst mechanism diminishes.
c. fluid may accumulate in the extremities.
d. water losses during respiration are increased.
As people age, total energy needs
a. increase each decade of life after the age of 30 years.
b. slowly decline throughout the aging process.
c. remain the same until the age of 70 years.
An example of resistance training is
a. swimming.
b. walking.
c. walking very quickly.
d. lifting weights.
The most beneficial rehydration fluid for most types of exercise is
a. commercial sports drinks.
b. diluted juice.
c. full-strength juice.
d. water.
It is common for patients with acute kidney failure to need
a. enteral nutrition.
b. calcium supplements.
c. blood transfusions.
d. assistance with feeding.
University
Tbilisi Medical Academy
Name
Subject
Essentials of Nutrition and Diet
Therapy
Surname
Semester
Date
Final Exam
Version N1
Test consists of 40 questions, each question – 1 point; total-40 points
1. The most commonly used assessment tool to monitor ongoing blood glucose control and
the risk of complications is
a. HbA1c.
b. serum triglyceride.
c. serum cholesterol.
2. The following energy substance is not considered a nutrient
a. carbohydrate.
b. alcohol.
c. fat.
d. water.
3. Studies indicate that exercise
a. decreases insulin production.
b. increases conversion of amino acids to glucose.
c. improves uptake of glucose by the cells.
d. causes unpredictable blood glucose levels.
4. Diets that are most likely to provide optimal nutrition contain
a. a variety of foods.
b. high-quality protein.
c. limited amounts of fat.
d. mostly fruits and vegetables.
5. Insulin is produced by the
a. α-cells of the pancreas.
b. β-cells of the pancreas.
c. glomerulus structure of the kidney.
d. pituitary gland.
6. Overnutrition results from
a. acute illness over a short time.
b. excess nutrient and energy intake over time.
c. an inadequate exercise routine.
d. eating a diet that is not varied in nutrients.
7. A risk factor for developing type 2 diabetes is
a. autoimmune destruction of the β cells of the pancreas.
b. a history of gestational diabetes.
c. a history of nephritis.
d. alcoholism.
8. Choose My Plate serves as a
a. nutrition education tool for the public.
b. reference guide for the hospitalized patient.
c. summary of the typical American food intake pattern.
9.
10.
11.
12.
13.
14.
15.
16.
d. guide to physical exercise across the health continuum.
The type of diabetes that always requires treatment with insulin for survival is
a. type 1 diabetes.
b. type 2 diabetes.
c. gestation diabetes.
d. drug-induced diabetes.
The system of reference values used for assessing and planning diets for healthy
populations is called
a. kilocalories.
b. Choose My Plate.
c. Dietary Reference Intakes (DRIs).
d. basal energy expenditure.
Persistent hyperglycemia during pregnancy is associated with an increased risk of
a. macrosomia.
b. preeclampsia.
c. diabetes insipidus.
d. phenylketonuria.
The increase in metabolic rate after a meal is called
a. satiety.
b. the metabolic stimulus.
c. the thermic effect of food.
d. the postmeal effect.
The form of insulin that has its peak action between 2 and 4 hours after administration is
the
a. rapid-acting form.
b. short-acting form.
c. intermediate-acting form.
d. long-acting form.
Total energy requirement involves a contribution from energy needs for basal energy
expendture, physical activity, and
a. breathing.
b. the amount of vitamin intake.
c. normal body temperature.
d. the thermic effect of food.
The hormone considered to act in an opposite manner to insulin is
a. glucagon.
b. pancreatin.
c. vitamin D.
d. thyroxine.
Iron needs increase during pregnancy because of
a. fetal bone formation.
b. increased maternal blood volume.
c. increased maternal iron excretion.
d. fetal breakdown of hemoglobin
17. The three common, long-term complications of diabetes affect cells in the
a. intestines, liver, and pancreas.
b. kidney, eye, and nerve tissue.
c. heart, blood vessels, and lungs.
d. skin, bone marrow, and lymph nodes.
18. A pregnancy is considered high risk if the mother
a. is 16 years old.
b. is 5 to 10 lb overweight before pregnancy.
c. has to fly during pregnancy.
d. is lactose intolerant.
19. The primary focus of medical nutrition therapy for diabetes care is to
a. reduce overall fat intake.
b. maintain glycemic control.
c. carefully follow the prescribed diet.
20. Adequate maternal folate intake around the time of conception helps prevent
a. growth retardation.
b. fetal anemia.
c. neural tube defects.
d. maternal hypertension.
21. It is common for patients with acute kidney failure to need
a. enteral nutrition.
b. calcium supplements.
c. blood transfusions.
d. assistance with feeding.
22. The hormone that stimulates milk production during lactation is
a. progesterone.
b. prolactin.
c. human growth hormone.
d. estrogen.
23. A decrease in the activation of vitamin D in kidney disease results in
a. hypercalcemia.
b. osteodystrophy.
c. hyperoxaluria.
d. calcium stone formation.
24. Infants younger than 1 year should not be given honey because it may contain
a. Clostridium Botulinum.
b. Staphylococcus aureus.
c. salmonellosis.
d. toxoplasmosis
25. The absence of urine production, indicating kidney failure, is called
a. hematuria.
b. oliguria.
c. proteinuria.
d. anuria.
26. A condition of concern during the adolescent years is
a. osteoporosis.
b. eating disorders.
c. mitral valve prolapse.
d. irritable bowel syndrome.
27. Medical nutrition therapy for acute glomerulonephritis consists of
a. sodium restriction at the onset of the disease process.
b. adequate calories to maintain metabolic needs.
c. fluid restriction until antibiotic therapy is completed.
28. An important function of calcium for the growing child is
a. muscle development.
b. regulation of metabolism.
c. regulation of blood pressure.
d. bone and tooth development.
29. Classic symptoms of glomerulonephritis include
a. anuria.
b. proteinuria.
c. low blood pressure.
d. bladder infection.
30. Foods that are considered a high risk for choking in young children include
a. oatmeal and whole milk.
b. crackers with cheese slices.
c. popcorn and peanut butter.
d. cooked green beans and carrots.
31. The type of diet recommended for a person with a kidney stone depends on
a. the person’s lifestyle.
b. the composition of the stone.
c. the person’s willingness to use drug therapy.
d. the person’s medical history.
32. Good choices for first solid foods for infants include
a. mashed potatoes.
b. puréed oatmeal.
c. whole milk yogurt.
d. infant rice cereal.
33. Elevated blood urea nitrogen, serum creatinine, and serum uric acid levels are reflected in
the laboratory finding of
a. metabolic acidosis.
b. azotemia.
c. nephrosis.
34. A child’s growth may be evaluated by using
a. calipers.
b. biochemical tests.
c. food diaries.
d. growth charts.
35. For patients with chronic kidney failure, potassium intake is based on
a. the presence of edema.
b. serum potassium level.
c. overall fluid balance.
d. blood pressure level.
36. Decreased absorption of nutrients in the elderly is caused by
a. the diminished secretion of digestive juices
b. the increased secretion of digestive juices and gastrointestinal muscle motility.
c. indigestion and constipation
37. Patients with chronic kidney disease often develop anemia due to
a. poor iron absorption.
b. generalized malnutrition.
c. an increased breakdown of hemoglobin.
d. the inadequate production of erythropoietin.
38. The kidney is responsible for stimulating red blood cell production through
a. erythropoietin secretion.
b. gluconeogenesis.
c. renin secretion.
d. vitamin D activation.
39. Factors that contribute to malnutrition in older adults include
a. a decline in kidney function.
b. loss of teeth or poorly fitting dentures.
c. eating snacks between meals.
d. increased vitamin requirements.
40. The massive edema of nephrotic syndrome is caused by
a. inadequate urine production.
b. large protein losses in the urine.
c. sodium retention by the kidneys.