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1.
What is the best approach to working C. Listen to the client. Encourwith a client with these circumstances: age and support the skills the
needs to reduce blood cholesterol lev- client has developed; The patient
els, knowledgeable about diets for hy- is knowledgeable with moderate
perlipidemia, able to devise healthy
readiness, so the RDN needs to
meal plans, has moderate readiness to find out what the client knows
independently follow the recommend- by listening to, encouraging, and
ed diet plan.
supporting the client to help him
be fully ready to execute the diet
A. Continue to provide dietary instruc- to reduce blood cholesterol.
tions to the client and closely monitor
compliance.
B. Help the client gain confidence
through listening, advising, and coaching.
C. Listen to the client. Encourage and
support the skills the client has developed.
D. Turn over responsibility for nutrition
care to the client.
2.
Which of the following is recommend- C. Eat small meals throughout the
ed to manage nausea?
day; Eating small meals throughout the day is recommended for
A. Avoid any product made with ginger individuals experiencing nausea.
B. Drink fruit juice throughout the day Ginger products can help alleC. Eat small meals throughout the day viate nausea symptoms. Spicy
D. Eat foods containing capsaicin
foods and sugar-containing foods
can exacerbate nausea so capsaicin-containing foods and fruit
juice are not recommended.
3.
Which category of the NFPE will be
B. Hair; Symptoms of polycystic
most relevant when evaluating a client ovarian syndrome, or PCOS, inwith suspected PCOS?
clude the following:
A. Edema
Infrequent menstrual periods, no
B. Hair
menstrual periods and/or irregular
C. Muscles
bleeding
D. Digestive system
Infertility due to lack of ovulation
1 / 30
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Increased hair growth on the face,
chest, stomach, back, thumbs or
toes
Acne, oily skin and dandruff
Weight gain, especially around
the mid-section
Insulin resistance or type 2 diabetes
High cholesterol and/or blood
pressure
Thinning hair on head
Pelvic pain
Depression and anxiety due to appearance and/or infertility
Endometrial cancer
Because of the potential for increased hair growth on the face
and body and thinning hair on
the head, hair would be a more
relevant assessment parameter
when performing a nutrition-focused physical examination on
a client/patient with suspected
PCOS.
4.
What component of serum cholesterol D. Low-density lipoprotein (LDL);
do plant stanols/sterols lower?
Plant stanols are often used in
A. Total cholesterol
place of statin therapy for lowering
B. High-density lipoprotein (HDL)
LDL, especially for those patients
C. Triglycerides
who are unable to tolerate statins.
D. Low-density lipoprotein (LDL)
5.
Based on this statement, determine
B. Contemplation; The classic inwhich stage of change a client is in: "I dicator for a patient in the conknow what I need to do to lose weight, templation stage of change is a
but I just can't do it."
"yes, but" statement. The majority
A. Precontemplation
of RDNs' clients are in the conB. Contemplation
templation stage when they come
to their first appointment.
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C. Preparation
D. Action
6.
If a client exploring readiness for
C. "What would need to happen
change rates confidence as a "4" and in order for your confidence to inimportance as a "10," which of the
crease to a '6'?"; Moving the talk
following questions/comments would about readiness for change forlead to the most productive conversa- ward is an important component
tion about change?
in motivational interviewing. OpA. "Why aren't you more motivated?" tion A is a poor question to ask as
B. "What can I do to help you?"
one rarely uses "why" with change
C. "What would need to happen in or- talk. Option B isn't specific enough
der for your confidence to increase to with regard to the behavior. Opa '6'?"
tion D is an affirmation and probaD. "It's encouraging that the imporbly won't move the discussion fortance rating is so high."
ward. Option C is the best question to ask as it invites an evocative response.
7.
According to the Nutrition Care
C. The diagnosis is no longer
Process, what does a "discontinued di- applicable based on assessment
agnosis" signify?
data; Use of nutrition diagnosis
A. The original diagnosis has been re- status labels is encouraged by the
moved from the eNCPT
Academy of Nutrition and DietetB. The patient is no longer receiving ics. In the Nutrition Care Process,
care at the facility
"discontinued diagnosis" is applicC. The diagnosis is no longer applica- able when the nutrition diagnoble based on assessment data
sis no longer exists because the
D. A new intervention is needed beclient's condition or situation has
cause a patient's medication has been changed and the current assessdiscontinued
ment data no longer support the
nutrition diagnosis.
8.
According to the WHO growth chart,
in what percentile is a 1-year-old boy
measuring 82 cm?
A. <15th
B. 50th
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D. >97th; 82 cm (32") is tall for
a 1-year-old boy, so he would be
above the 97th percentile.
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C. 85th
D. >97th
9.
After defining the nutrition problem, A. Set the parameters of the aswhich of the following is the correct
sessment, collect data, analyze
sequence of steps a community nutri- and interpret the data, share the
tionist should follow in assessing the findings, and set priorities; A comneeds of the community?
munity nutrition needs assessA. Set the parameters of the assess- ment must occur in the sequenced
ment, collect data, analyze and inter- order listed in option A.
pret the data, share the findings, and
set priorities.
B. Set priorities, collect data, set the
parameters of the assessment, analyze
and interpret the data, and share the
findings.
C. Choose a plan of action, collect data,
set the parameters of the assessment,
share the findings, and analyze and interpret the data.
D. Collect data, analyze and interpret
the data, set the parameters, share the
findings, and set the priorities.
10. What is the term for a care delivery
C. Patient-centered medical
model in which multidisciplinary treat- home; A patient-centered medical
ment is coordinated through a primary home is a care delivery model in
care physician to ensure the patient which multidisciplinary treatment
receives necessary care in a timely, in- is coordinated through a primary
dividualized manner?
care physician to ensure the paA. Health maintenance organization
tient receives necessary care in a
B. Ambulatory care facility
timely, individualized manner.
C. Patient-centered medical home
A health maintenance organizaD. Group practice
tion, or HMO, is network of doctors, hospitals, and other health
care providers who have agreed
to accept a certain level of payment for any provided services,
which lowers costs for members.
4 / 30
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An ambulatory care facility is
an outpatient care center that
provides services like diagnosis,
treatment, consultation, and intervention. Group practice refers to a
private practice shared by multiple
providers.
11. Approximately how many carbohydrate servings are 48 grapes?
A. 1
B. 2
C. 3
D. 4
C. 3; There are roughly 15 grapes
in 1 carbohydrate serving, so
48 grapes would provide approximately 3 carbohydrate servings.
12. What is the term for the measurement A. Z score; Z-scores are often
of an individual's derivation from the used with anthropometric data.
mean of the reference population?
They express the anthropometA. Z score
ric value as a number of stanB. P-value
dard deviations or Z-scores below
C. Chi-squared
or above the reference mean or
D. Comparative standard
median value. Comparative standards evaluate the actual value of the measured or observed
data against accepted standards,
recommendations, and/or goals.
P-values are a measure related to
probability of statistical reliability.
Chi-squared compares two variables in a contingency table to see
if they are related
13. Which of the following is an etiology of D. Genetic predisposition; Etiolooverweight?
gy is the cause of a condition
A. Body mass index of 25-29.9
or disease. Genetic factors are
B. Increased diabetes risk
among the causes of overweight
C. Being in precontemplative stage of and obesity. Body mass index of
change
25-29.9 and increased risk of diaD. Genetic predisposition
betes may result from overweight.
5 / 30
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Stages of change relate to nutrition therapy.
14. How many pounds are recommended
for an overweight woman to gain during her pregnancy?
A. 0
B. 5-10
C. 15-25
D. 28-40
C. 15-25; All women should gain
weight during pregnancy. Recommendations for gaining 28 to 40
lb in pregnancy are applicable to
underweight women. It is recommended that overweight women
gain 15 to 25 lb during pregnancy.
15. Which component of nutrition assess- D. Client history; During the monment is not reassessed during moni- itoring and evaluation step of the
toring and evaluation?
Nutrition Care Process, client hisA. Anthropometric data
tory is not reassessed.
B. Nutrition-focused physical findings
C. Biochemical data, medical tests, and
procedures
D. Client history
16. What is the most appropriate nutriB. Offer a high-calorie bedtime
tion intervention for a 10-year-old with snack; The peak activity for ADHD
ADHD who takes Adderall and has
medication is scheduled around
a BMI-for-age less than the 5th perschool hours. A side effect of
centile?
ADHD medication is decreased
A. Provide snacks to eat during recess appetite, so it is recommended to
B. Offer a high-calorie bedtime snack provide the child with a larger bedC. Make a lunch consisting of favorite time snack when the side effects
foods
are low and the appetite is imD. Have the teacher monitor the child's proved.
intake
17. What is the first step in the Nutrition
Care Process?
A. Nutrition screening
B. Nutrition assessment
C. Nutrition diagnosis
D. Goal setting
18.
6 / 30
B. Nutrition assessment; Sequential steps in the Nutrition Care
Process are nutrition assessment,
nutrition diagnosis, nutrition intervention, and nutrition monitoring
and evaluation.
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An RDN is planning a community nutri- B. Define the management systion program and has already complet- tem; Defining the management
ed the community needs assessment, system comes next. Identifying
defined program goals and objectives, funding systems, seeking supand developed a program plan. What is port from stakeholders, and implethe next step in the process?
menting the program come later.
A. Identify funding sources.
B. Define the management system.
C. Implement the program.
D. Seek support from the stakeholders
19. Which of the following represents a for- D. Respond to patient's questions
mative evaluation of a community nu- after presenting a motivational
trition program designed to encourage video at prenatal checkups; Formore first-time mothers to breastfeed? mative evaluation identifies learnA. Determine the percentage of
er misconceptions, struggles, and
first-time mothers who breastfeed be- learning gaps before and during
cause they watched a motivational
the educational process. Fielding
video when they attended prenatal
questions after presenting a video
checkups
will help to identify these patient
B. Calculate the increase in first-time challenges before giving birth.
mothers who breastfeed because they
watched a motivational video when
they attended prenatal checkups
C. Offer a take-home version of a motivational video to be watched at patient's leisure
D. Respond to patient's questions after
presenting a motivational video at prenatal checkups
20. What benchmark is commonly used to C. 1 year; In determining if weight
measure if weight loss is successful? loss has been successful, 1 year
A. 3 months
of maintenance is commonly used
B. 6 months
as the benchmark.
C. 1 year
D. 2 years
21.
7 / 30
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What is the upper threshold for low
birthweight?
A. 5.4 pounds
B. 5.1 pounds
C. 4.5 pounds
D. 3.5 pounds
A. 5.4 pounds; An infant born at
5.4 pounds or less is considered
low birthweight.
22. Using food-based menu planning, the B. 2 oz; Schools must offer 2 oz or
required portion size for meat/meat al- equivalent of meat/meat alternate
ternate served in a reimbursable lunch to students in grades 9 through
to students in grades 9 through 12
12.
must be
A. 1 oz.
B. 2 oz.
C. 3 oz.
D. 4 oz.
23. Which of the following is true when
D. A minimum of two colleccollecting data for a community needs tion methods is recommended; In
assessment?
community needs assessments,
A. Collected data should be from within it is recommended that a combithe past 5 years
nation of two or more data-colB. Data collection by direct observa- lection methods be employed to
tion is discouraged
confirm or support initial findings.
C. Only quantitative data are relevant Direct observation is encouraged
D. A minimum of two collection meth- and both qualitative and quantitaods is recommended
tive data are considered relevant.
Collected data should be from the
past 6 months with very limited
exceptions.
24. Using the Hamwi formula, what is the
ideal body weight for a female who is
70 inches tall and has a small body
frame?
A. 120 pounds
B. 135 pounds
C. 150 pounds
D. 165 pounds
8 / 30
B. 135 pounds; The Hamwi formula for women with small frame is:
100 lb + (5 lb for every inch over 60
inches) and subtract 10% for small
frame.
100 lb + (10 inches x 5 lb) = 150
lb.
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10% of 150 lb =15 lb.
150 lb - 15 lb = 135 lb
25. What would the nitrogen balance be C. 2 grams; Nitrogen balance forfor a patient with a 24-hour urinary ni- mula: total protein intake (g)/6.25
trogen excretion of 14.3 grams and a g - (UUN + 4 g for insensible lossprotein intake of 102 grams?
es)
A. +16.3 grams
Step 1: Convert the total protein
B. 16.3 grams
intake to grams of nitrogen. To calC. 2 grams
culate this, divide the total protein
D. +2 grams
intake of 102 g by 6.25 g of protein
per gram of nitrogen.
102 g/6.25 = 16.32 g
Total nitrogen intake = 16.32 g
Step 2: Determine the total excretion. To calculate this, add 14.3 g
of nitrogen excreted in the urine
over 24 hours (UUN) + 4 g of nitrogen for insensible losses (from
sweat, gastrointestinal tract) in a
24-hour period.
14.3 g + 4 g = 18.3
Total nitrogen excreted = 18.3 g
Step 3: Calculate nitrogen balance. Take total nitrogen intake of
16.32 g and subtract total nitrogen
excretion of 18.3 g.
16.32 g - 18.3 g = -1.98 g
Nitrogen Balance rounded up = -2
g nitrogen.
This patient has a negative nitrogen balance, so the dietetic practitioner will need to assess if an increase in protein intake is needed.
26. Growth acceleration during puberty is A. insulin; Pubertal growth accellargely related to the synergetic effects eration is largely due to the synof gonadal sex steroids, growth hor- ergetic effects of increased se9 / 30
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mone, intracellular growth factor-1 and cretion of gonadal sex steroids,
______.
growth hormone (GH), and IGF-I
A. insulin
and insulin.
B. cortisol
C. glucagon
D. thyroxine
27. What is the primary purpose of a nutri- C. Altering or eliminating the etition intervention?
ologies of a nutrition diagnosis;
A. Alleviating symptoms of a nutrition A nutrition intervention is a purproblem
posely planned action intended to
B. Determining the cause of a person's change a nutrition-related behavnutrition problem
ior, risk factor, environmental conC. Altering or eliminating the etiologies dition, or aspect of health status
of a nutrition diagnosis
to resolve or improve the identiD. Researching potential cures for con- fied nutrition diagnosis or nutrition
ditions with nutrition implications
problem. It is less often directed at
alleviating signs and symptoms.
28. Which of the following is an example of D. Whether participants learned
an impact evaluation in the final step the role of carbohydrate countof a community nutrition program for ing in managing their condition;
type 2 diabetes?
An impact evaluation measures
A. Whether the age of participants re- whether and to what extent a
flected the target population
program or intervention achieved
B. Whether staff were trained using
its stated goals and describes
standardized patient education mod- the specific effect of activities
ules
on the target population. EvaluC. Whether patient data were accurate- ating if participate age reflects
ly recorded and properly stored
target population or if staff were
D. Whether participants learned the
trained with standardized materole of carbohydrate counting in man- rials occurs during the process
aging their condition
evaluation. Evaluating if data were
recorded and stored properly occurs during structural evaluation.
29. Which is the best tool for the commu- D. Survey; All options listed are
nity nutritionist to use to learn what lo- methods for obtaining data. A
cally grown foods residents consume health risk appraisal character10 / 30
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most frequently?
A. Health Risk Appraisal
B. Screening
C. Focus Group
D. Survey
izes a population's general health,
screening represents a preventive
health activity, and, although a focus group would be plausible, it is
a very expensive way of obtaining
both qualitative and quantitative
information. Surveys are the least
expensive systematic study of a
cross-section of individuals.
30. Which of the following is typically used B. Rice; Rice cereal is less allerin infant cereal because of low allergy genic; it is typically the first grain
risk?
introduced to infants.
A. Corn
B. Rice
C. Wheat
D. Oats
31. Which of the following gastrointestinal B. Ghrelin; Ghrelin is a gastroinhormones has the effect of increasing testinal hormone produced by epthe consumption of food?
ithelial cells lining the fundus of
A. Cholecystokinin
the stomach; it appears to be a
B. Ghrelin
stimulant for appetite and feedC. Enterostatin
ing but is also a strong stimulant
D. Peripheral hormone peptide YY
of growth hormone secretion from
the anterior pituitary.
32. Which of the following must be true for B. Contain less than 3 g fat; Fola serving of food to be labeled as low lowing food labeling laws, to be
fat?
identified as low in fat, a serving
A. Contain less than 0.5 g fat
of food must contain less than 3 g
B. Contain less than 3 g fat
fat. A serving of food with less than
C. Contain 25% less fat than the full fat 0.5 g fat is considered fat free.
food
D. Contain 1313 fewer calories or 50%
less fat than the full fat food
33. Which of the following nutrients
A. Vitamin A; Vitamin B-6 is washould a pregnant person avoid in ex- ter soluble, and folic acid and iron
cessive amounts?
should be increased during preg11 / 30
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A. Vitamin A
B. Vitamin B-6
C. Folic acid
D. Iron
nancy. A pregnant person should
avoid excessive intake of vitamin
A.
34. Carotenoids like lutein and zeaxanA. Kale; Lutein and zeaxanthin are
thin have been studied for their role
found in green leafy vegetables
in preventing or delaying cataracts
(eg, kale, spinach, broccoli, peas,
and age-related macular degeneration. and lettuce) and egg yolks.
Which food is the best source for these
carotenoids?
A. Kale
B. Almonds
C. Apples
D. Yogurt
35. The US Department of Agriculture
C. 1/4; Schools participating in
School Meals Initiative for Healthy Chil- the USDA School Lunch Program
dren requires that the schools partici- must provide 1/3 of the RDA for
pating in the National School Breakfast protein, calcium, iron, and vitaProgram provide _____ of the Recom- mins A and C for each age/grade
mended Dietary Allowance (RDA) for group for lunch meals, whereprotein.
as the USDA School Breakfast
A. 1/2
Program requires serving 1/4 of
B. 1/3
the RDA of those nutrients for
C. 1/4
each age/grade group for breakD. 1/5
fast meals.
36. Which of the following is true of a child C. The child has a thin body habiwho consistently plots at the 5th per- tus; Successive measurements
centile on the weight-for-length/stature plotted on growth charts can be
Centers for Disease Control and Pre- used to determine whether a child
vention growth chart but is growing? is maintaining rate of growth. A
A. The child demonstrates a negative change in rate of growth pattern
pattern of growth.
over time can identify potential
B. The child demonstrates failure to
risk. Therefore, it is important to
thrive.
look for pattern consistency; the
C. The child has a thin body habitus. child is most likely small for age
12 / 30
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D. The child is reflecting a change in
growth velocity.
37. A child's weight is plotted at the 50th
percentile on the growth chart. This
means that the child's weight is
A. greater than or equal to that of half
the children of the same sex and ethnicity.
B. greater than or equal to that of half
the children of the same age.
C. greater than or equal to that of half
the children of the same ethnicity.
D. greater than or equal to that of half
the children of the same age and sex.
given the consistency in these
measurements.
D. greater than or equal to that of
half the children of the same age
and sex; Growth charts consider
the child's age and sex, not ethnicity.
38. Which of the following should be limit- D. Coffee; The caffeine found in
ed in a patient with diarrhea?
coffee can irritate the digestive
A. Oatmeal
system and worsen diarrhea that
B. Potatoes
already is present.
C. Banana
D. Coffee
39. Which of the following components of C. Monitoring and Evaluation; Nuthe Nutrition Care Process are pertrition Monitoring & Evaluation ocformed during the same step?
cur during the fourth step of the
A. Assessment and Intervention
Nutrition Care Process.
B. Monitoring and Diagnosis
C. Monitoring and Evaluation
D. Diagnosis and Intervention
40. Which of the following fish contains
a higher level of methyl mercury and
therefore should be avoided during
pregnancy?
A. Salmon
B. Pollack
C. Swordfish
D. Tilapia
13 / 30
C. Swordfish; Swordfish is a large
predatory fish and therefore exposed to more mercury. The US
Food and Drug Administration has
specifically identified swordfish as
being high in mercury.
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41. Which of the following is completed as D. Implementing appropriate nupart of the third step in the Nutrition trition interventions that are taiCare Process?
lored to the patient/client's needs;
A. Identifying whether or not intake is The nutrition care process cominadequate or excessive compared to prises ADIME (assessment, diagactual or estimated needs.
nosis, intervention, and monitorB. Assessing nutrition problems that ing and evaluation); intervention is
relate to medical or physical condithe third step.
tions.
C. Interpreting laboratory data and
tests.
D. Implementing appropriate nutrition
interventions that are tailored to the
patient/client's needs.
42. In terms of CVD, what are sedentary be- A. Modifiable risk factors; Modihavior, body mass index, and diabetes fiable risk factors are behaviors
collectively considered?
and measurements that elevate
A. Modifiable risk factors
or lower a person's risk of disB. Comorbidities
ease but that can theoretically be
C. Nonmodifiable risk factors
changed if certain measures are
D. Nutrition-focused physical findings taken. Body mass index, sedentary behavior, and diabetes are
all risk factors for cardiovascular disease that could potentially be modified, thereby lowering
the risk. Nonmodifiable risk factors
would include variables such as
age and family history.
43. The purpose of the nutrition diagnosis D. identify and label the nutrition
step in the Nutrition Care Process is problem; Identification and labelto:
ing of the nutrition problem ocA. identify the medical diagnosis of the cur during the nutrition diagnosis
client.
step.
B. plan interventions to address the
nutrition problem.
C. determine interventions, goals and
expected outcomes.
14 / 30
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D. identify and label the nutrition problem.
44. Motivational interviewing is best de- C. inspires neutral or reluctant
scribed as a style of counseling that: clients to change; Health care proA. challenges clients to face their is- fessionals must be aware of this
sues of denial.
style of counseling, which repreB. explores ways to increase self-ac- sents an effective, brief intervenceptance.
tion with applications in all realms
C. inspires neutral or reluctant clients of health care, including nutrition
to change.
and dietetics. The key to motiD. focuses on unhelpful thought pat- vational interviewing is that it foterns and problematic thoughts.
cuses on the client's values, beliefs, and internal motivations that
guide them to action, if any. It
should be used with other comprehensive approaches to counseling to inspire change in clients
who may otherwise feel neutral
or reluctant to change. Focusing
on unhelpful thought patterns is a
tenet of cognitive behavioral therapy, and exploring ways to increase self-acceptance is a tenet
of humanistic therapy.
45. A patient in residential care receives a B. 680 kcal; The kilocalories deparenteral formula of D40W of 500 ml livered by dextrose in solution
in one day. The number of kilocalories is 3.4 kcal/g—not the typical 4
delivered is A. 560 kcal
kcal/g—so the correct answer is
B. 680 kcal
680 kcal. In 1 L of D40W, there is
C. 800 kcal
400 g dextrose, but the patient is
D. 920 kcal
only receiving 500 ml; thus, 200 g
dextrose x 3.4 kcal/g = 680 kcal.
46. Which classic vitamin deficiency is
known for the four Ds: dermatitis, dementia, diarrhea, and death?
A. Thiamine
15 / 30
B. Niacin; Dermatitis, dementia,
diarrhea, and death are the typical
symptoms of pellagra, a disease
caused by niacin deficiency.
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B. Niacin
C. Biotin
D. Folic acid
47. Body mass index (BMI) is a better indi- B. the ratio of weight to height;
cator of obesity than body weight be- BMI is calculated using weight
cause BMI is
(kg)/height (m2). BMI is based on
A. the ratio of height to weight
the ratio of a person's weight to
B. the ratio of weight to height
height and has been shown to
C. determined by indirect calorimetry be a reliable indicator of body fatD. determined by direct calorimetry
ness.
48. Which of the following reflects
B. Red blood cell folate; Red blood
long-term folate status?
cells (RBC) collect folate durA. Serum folate
ing formation. Because red blood
B. Red blood cell folate
cells live for 2 to 3 months and
C. Homocysteine concentration in the contain the folate since formablood
tion, RBC assessment provides
D. Serum methylmalonic acid
longer-term folate status.
49. When considering cow's milk versus A. Breastmilk contains less probreastmilk, which of the following is tein; Breastmilk is lower in protrue?
tein than cow's milk (6% to 7% of
A. Breastmilk contains less protein.
calories in breastmilk vs 20% in
B. Breastmilk provides more calcium. cow's milk). It also has less calciC. Cow's milk provides less potassium um, sodium, and potassium than
and sodium.
cow's milk. Casein accounts for
D. Cow's milk contains a lower propor- 80% of the protein in cow's milk,
tion of casein compared to whey pro- so it actually has a higher proportein.
tion of casein compared to whey
protein.
50. The optimal length of time to breastfeed an infant is
A. 3 months
B. 6 months
C. 9 months
D. 12 months
51.
16 / 30
D. 12 months; Breastfeeding is
recommended for the first 12
months of life and for as long as
is mutually desired by the mother
and baby.
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How many kilocalories per ounce does A. 20; A standard infant formula
a standard infant formula provide?
contains 20 kcal/oz. Higher-conA. 20
centrated formulas are appropriB. 22
ate for preterm infants or for those
C. 25
with specific diseases.
D. 28
52. Children on strict vegan diets may be
deficient in
A. vitamin B-6.
B. magnesium.
C. vitamin B12.
D. folate.
C. vitamin B12; Vegans do not
consume meat, eggs, or dairy,
which are high in vitamin B12.
Children have periods of rapid
growth, so careful planning is
needed to prevent a vitamin B12
deficiency. It is suggested that
children on a vegan diet consume
vitamin B12-fortified foods, such
as most breakfast cereal, soy beverages and plant-based meat substitutes to avoid deficiency.
53. What nutrient intake should be
screened in older adults to identify
susceptibility to infection?
A. Riboflavin
B. Selenium
C. Calcium
D. Zinc
D. Zinc; Decreased consumption
of dietary zinc has been associated with the aging process. Zinc
is critical for the immune system,
and deficiency can lead to depressed immunity and increased
susceptibility to infection.
54. What is the daily recommended daily
fiber goal for a 10-year-old boy?
A. 14 g/day
B. 19.6 g/day
C. 22.4 g/day
D. 25.2 g/day
D. 25.2 g/day; The daily recommended fiber goals for children
are:
14 g/day for all children age 1-3
16.8 g/day for girls age 4-8
19.6 g/day for boys age 4-8
22.4 g/day for girls age 9-13
25.2 g/day for boys age 9-13
55. A deficiency of vitamin B-12 in older
adults is most likely due to
A. diverticulosis.
C. atrophic gastritis; Vitamin B-12
requires hydrochloric acid in the
stomach to be released from its
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B. fat malabsorption.
C. atrophic gastritis.
D. gallbladder disease.
peptide bonds. It then binds with
intrinsic factor in the stomach and
is absorbed in the ileum. If a person has atrophic gastritis, which
increases significantly with age,
there is reduced hydrochloric acid
secretion. This can result in decreased bioavailability of vitamin
B-12.
56. Which of the following foods should a A. King mackerel; People who are
pregnant person avoid?
pregnant should avoid consuming
A. King mackerel
mackerel because of its mercury
B. Tuna
content.
C. Trout
D. Shrimp
57. Currently, which of the following nutri- D. Iron; Of all nutrients listed, iron
ents is determined to be the most defi- has shown to be the most deficient
cient among children and adolescents in US children and adolescents.
in the United States?
A. Calcium
B. Fiber
C. Vitamin A
D. Iron
58. Which of the following examples of a D. Whole grain crackers and
snack provided at a child care center peanut butter; The nutritional rewould meet reimbursement guidelines quirement for snacks is that they
and comply with USDA regulations for must provide a combination of
Child and Adult Care Food Program
at least two food items from the
meals?
meat, milk, grains, and fruit/vegA. Hard boiled egg and water
etable categories. Furthermore, to
B. Chocolate milk and grapes
be eligible for reimbursement, any
C. Apple slices and orange wedges
milk must be unflavored if providD. Whole grain crackers and peanut
ed to children age 1-5 years. The
butter
foods listed in choice D represent
the only answer where two different groups were combined and
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meet the reimbursement requirements.
59. How many carbohydrate servings are
in 45 grapes?
A. 1
B. 2
C. 3
D. 4
C. 3; There are roughly 15 grapes
in 1 carbohydrate serving, so
45 grapes would provide approximately 3 carbohydrate servings.
60. Which enteral feeding access device C. Percutaneous jejunostomy; The
will deliver nutrition past the ligament ligament of Treitz ligament marks
of Treitz?
the separation of the duodenum
A. Nasogastric
and jejunum. To bypass it, one
B. Nasoduodenal
would need to use percutaneous
C. Percutaneous jejunostomy
jejunostomy for feeding access.
D. Percutaneous gastrostomy
61. What is the osmolality of an isotonic
enteral formula?
A. 0 mOsm/kg
B. 300 mOsm/kg
C. 550 mOsm/kg
D. 700 mOsm/kg
B. 300 mOsm/kg; The osmolality of an isotonic solution (one
that is similar to the osmolality of
the blood) is approximately 300
mOsm/kg.
62. Refeeding syndrome is characterized
by low serum concentrations of
A. phosphorus, potassium, magnesium.
B. sodium, phosphorus, magnesium.
C. sodium, potassium, phosphorus.
D. potassium, magnesium, sodium.
A. phosphorus, potassium, magnesium; Refeeding syndrome occurs when previously malnourished patients are fed with high
carbohydrate loads; the result is
a rapid fall in phosphate, magnesium, and potassium, along with
an increasing extracellular fluid
volume. This leads to a variety of
complications, such as cardiac arrhythmia and seizures.
63. In the Nutrition Care Process, stateC. PES statements; These statements in the format of "[Nutrition prob- ments are written in the style of
lem] related to ____ as evidenced by the classic PES statement.
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____" are classified as:
A. intake critiques.
B. NCP links.
C. PES statements.
D. nutrition concerns.
64. Why does the American Academy of D. Daily intake recommendations
Pediatrics (AAP) recommend that early may be exceeded by consuming
care and education programs (ECEs) juice at home; Because children
serve limited or no juice to children in may drink juice at home, the AAP
their charge?
recommends that ECEs limit or
A. Cross-contact can harm the health omit juice servings so that the daiof children with allergies to foods
ly recommended intake of 4 oz
found in juice
(120 mL) to 6 oz (180 mL) is not
B. Students who are not served juice exceeded.
at home may be hesitant to accept a
serving of juice
C. Budget constraints may affect an
ECE's ability to offer juice consistently
D. Daily intake recommendations may
be exceeded by consuming juice at
home
65. What represents the ability to obtain D. Cultural skill; According to the
an accurate and culturally relevant pa- Campinha-Bacote model, cultural
tient/client history and conduct an as- skill is the the ability of health care
sessment?
providers to obtain an accurate
A. Cultural knowledge
and culturally relevant history and
B. Cultural awareness
conduct a physical assessment.
C. Cultural desire
D. Cultural skill
66. In the ETHNIC model of culturally com- C. explanation; In the ETHNIC
petent care, the "E" stands for _____. model, explanation about the culA. education
ture and condition or illness by the
B. empathy
client is the first step.
C. explanation
D. expectations
67.
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Regarding food-drug interactions,
B. MAO inhibitors and tyrawhich food-drug combination requires mine-containing foods; There are
client counseling?
no known interactions between
A. Warfarin and vitamin D-containing warfarin and vitamin D foods, and
foods
prednisone and sibutramin do not
B. MAO inhibitors and tyramine-con- interact with vitamin C foods or
taining foods
juices.
C. Prednisone and grapefruit juice
D. Sibutramine and vitamin C-containing foods
68. Which electronic health record style B. ADIME; SOAP is the oldest type
was created to reflect the nutrition care of medical chart documentation;
process?
PIE and Focus are a blending of
A. SOAP
chart notes types. ADIME, which
B. ADIME
stands for "assessment, diagnoC. PIE
sis, intervention, monitoring, and
D. Focus
evaluation," reflects the nutrition
care process.
69. The Institute of Medicine's recomA. 0.5; The Institute of Medicine's
mended rate of weight gain per week recommended rate of weight gain
during the second and third trimesters per week during the second and
for pregnant people whose body mass third trimesters for pregnant peoindex (BMI) is greater than 30 is ___
ple whose BMI is greater than 30
pounds.
is 0.5 pounds.
A. 0.5
B. 0.6
C. 0.7
D. 0.8
70. Which of the following individuals
D. A man on aspirin therapy; A
would be LEAST likely to be at risk for patient on aspirin therapy may be
vitamin B-12 deficiency?
at risk for iron deficiency but not
A. A vegan
vitamin B-12 deficiency.
B. A woman with polycystic ovarian
syndrome taking metformin therapy
C. An elderly individual on a proton
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pump inhibitor
D. A man on aspirin therapy
71. Which of the following statements re- D. Weight bias exists among reggarding the concept of weight bias is istered dietitian nutritionists who
true?
work with obese clients; Weight
A. Training in a health care field com- bias exists in clinical settings and
pletely thwarts weight bias from devel- research from the Yale Universioping.
ty Rudd Center for Food Policy
B. Perception of weight bias is almost and Obesity demonstrates that it
always the result of patient misunder- is common among registered distanding.
etitian nutritionists. Even RDNs
C. Weight bias is unpleasant but
who work with obese clients have
doesn't have an impact on health out- weight bias and may not recogcomes.
nize it.
D. Weight bias exists among registered
dietitian nutritionists who work with
obese clients.
72. Which one of the following foods
should be avoided in treatment of
gout?
A. Low-fat yogurt
B. Rye bread
C. Banana
D. Regular soft drinks
D. Regular soft drinks; The American College of Rheumatology
Guidelines for the Management
of Gout state that these patients
should avoid high-fructose corn
syrup, which is found in regular
soft drinks. Low-fat dairy products,
fruits and vegetables, and whole
grains are recommended.
73. All breastfed infants should receive
how many IUs of vitamin D per day
during the first 2 months of life?
A. 400
B. 500
C. 600
D. 800
A. 400; Because breastmilk alone
does not provide infants with an
adequate intake of vitamin D, it is
recommended that breastfed infants should be given 400 IU (10
mcg) vitamin D beginning within
the first 2 months of life.
74. What is deficient in patients with pella- D. Niacin; Pellagra is a disease
gra?
marked by niacin deficiency. It is
A. Folate
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B. Vitamin D
C. Sodium
D. Niacin
rhea, dermatitis, dementia, and
death.
75. In the Nutrition Care Process, where C. Anthropometric measureshould the dietetics professional note ments; Like weight, height, and
the client's BMI?
other physical measurements,
A. Food/nutrition-related history
BMI is an anthropometric meaB. Biochemical data, medical tests and surement. Biochemical data enprocedures
compass laboratory values, food
C. Anthropometric measurements
and nutrition history includes inD. Nutrition-focused physical findings take data, and nutrition-focused
findings identify physical effects
like poor skin turgor or sunken
eyes.
76. What population experiences the most A. Immunocompromised individserious consequences of foodborne uals; People with compromised
illness?
immune systems, the body's deA. Immunocompromised individuals fense system against illnesses,
B. Teenagers
are at a higher risk for conseC. Women of childbearing age
quences from foodborne illness.
D. Children in daycare settings
77. What is used to determine body density by measuring the amount of air
displaced?
A. Bod pod machine
B. Dual energy x-ray absorptiometry
(DEXA)
C. Magnetic resonance imaging (MRI)
D. Ultrasound
A. Bod pod machine; The bod pod
machine uses air displacement
plethysmography (ADP) to measure body composition. This machine has been shown to be just
as accurate as underwater weighing.
78. If a patient has lesions on the gums
C. Vitamin C; Vitamin C helps keep
and pinpoint hemorrhages on his skin, the gums healthy, heal any cuts
what vitamin is this patient most likely and wounds, and protect from
deficient in?
bruising.
A. Thiamin
Thiamin may contribute to mainB. Magnesium
taining mental function and help
regulate metabolism. Magnesium
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C. Vitamin C
D. Selenium
signals muscles to relax and contract, may help maintain immune
response, and promotes normal
blood pressure. Selenium aids cell
growth and boosts immune function.
79. Which of the following is a good indicator of central adiposity?
A. Hip circumference
B. Basal metabolic rate
C. Waist circumference
D. Body weight
C. Waist circumference; Central
adiposity is the accumulation of fat
in the lower torso around abdominal area.
80. What is the body mass index range for B 30-34.9; Overweight BMI is
class I obesity?
25.0-29.9. Obesity (class 1) BMI
A 25-29.9
is 30.0-34.9. Class 2 obesity is
B 30-34.9
marked by a BMI of 35.0-39.9.
C 35-39.9
Class 3 obesity, classified as exD e40
treme or severe obesity, is marked
by a BMI of 40.0-49.9.
81. Which of these individuals is most like- B. An alcoholic man; The abuse
ly to present with Wernicke-Korsakoff of alcohol often leads to a severe
syndrome?
form of thiamin deficiency known
A. A premature infant
as Wernicke-Korsakoff syndrome.
B. An alcoholic man
C. A postmenopausal woman
D. A disabled child
82. Which of the following measures of
D. Waist circumference; Waist cirobesity correlate best with obesity-as- cumference is the best corresociated disease risk?
late to obesity-associated disease
A. BMI
risk.Skinfold thickness accuracy
B. Skinfold thickness
can vary greatly. BMI accuracy deC. Abdominal body shape index
creases with muscle wasting and
D. Waist circumference
increases based on muscularity,
age, sex, and ethnicity. There is no
abdominal body shape index that
has been validated.
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83. What feature of the Nutrition Care
D. Standardized language; StanProcess allows for drawing compar- dardized language allows for a
isons regarding nutrition problems
system of comparison of patient
and outcomes across health care sys- nutrition issues/problems across
tems?
health care systems. No matter
A. Research opportunities
who is reading the patient note
B. PES statements
along the spectrum of care, all inC. Information sharing technologies dividuals will understand the terD. Standardized language
minology by this standard language that has been established
for nutrition care.
84. What comprises a PES statement?
A. possibilities, effects, solutions.
B. problem, etiology, sign/symptoms.
C. people, efforts, satisfaction.
D. probabilities, end products, significant information.
B. problem, etiology, sign/symptoms; PES stands for problem, etiology (or cause of problem), and
the signs and symptoms that describe the nutrition problem.
85. What is the primary purpose of the Nu- D. It provides a framework for
trition Care Process?
individualizing patient/client care;
A. It mandates a required care delivery The Nutrition Care Process repsystem to all RDNs
resents a framework for providB. It establishes responsibilities and ing high-quality, individualized nuprofessional norms for RDNs
trition care. The Nutrition Care
C. It advocates for RDNs to be included Process takes into account the
on health care teams
patient's/client's needs and valD. It provides a framework for individu- ues while considering the best evializing patient/client care
dence available to make decisions
about nutrition care.
86. The objectives of patient-centered
B. increase confidence for making
counseling for dietary change are to in- dietary changes; The actions in recrease awareness of diet-related risks, sponses A, C, and D are all part of
provide nutrition knowledge, enhance helping clients to make changes.
skills to promote long-term changes in However, patient-centered counintake, and _____.
seling is focused on helping paA. reinforce patient values
tients develop a sense of self
B. increase confidence for making di- so they can realize how their
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etary changes
attitudes, feelings, and behavior
C. solicit social support from family
are being negatively affected. The
members and friends
goal is to have the patient confiD. identify and minimize external barri- dent enough to make the dietary
ers to change
change.
87. Resting energy expenditure (REE) is
most affected by
A. body composition.
B. physical activity.
C. time of day.
D. food intake.
A. body composition; Resting energy expenditure (REE) is the
amount of energy needed to maintain basic body systems and
body temperature at rest. Weight,
height, and age are needed to calculate REE.
88. Why are mixed-consistency foods not A. There is an increased risk of asrecommended for patients with dys- piration; Mixed-consistency foods
phagia?
include both solids and liquids.
A. There is an increased risk of aspira- Mixed-consistency foods can be
tion
more challenging to swallow, beB. There is an increased risk of heart- cause adequate ability to hanburn
dle both the solid and the liqC. There is an increased risk of discom- uid component of these items is
fort related to jaw fatigue
required, which in turn requires
D. There is an increased risk of expo- more advanced oral control and
sure to food allergens
swallowing coordination abilities.
People with dysphagia have an increased aspiration risk when eating mixed-consistency foods.
89. The ethical principle of autonomy is D. a patient at end of life is allowed
supported when
to refuse parenteral nutrition; AuA. a clinician treats all patients with
tonomy is the agreement to resimilar attention.
spect another's right to determine
B. explaining the benefits and risks of a course of action for himself or
enteral nutrition to the wife of a man in herself, or the support of another's
a persistent vegetative state.
independent decision making.
C. enteral nutrition is provided to a
postoperative patient requiring mechanical ventilation.
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D. a patient at end of life is allowed to
refuse parenteral nutrition.
90. Rickets is a result of which vitamin de- C. Vitamin D; The most obvious
ficiency?
sign of vitamin D deficiency is
A. Vitamin A
abnormality of bones. Rickets is
B. Vitamin C
caused by vitamin D deficiency
C. Vitamin D
and is characterized in children by
D. Vitamin K
bowed legs from bones too weak
to support the body weight and a
protruding belly that results from
lax abdominal muscles.
91. Taking folate supplements that exceed C. Vitamin B12; Large doses of
recommendations might mask defifolate supplements might mask
ciency of which of the following nutri- a vitamin B12 deficiency beents?
cause they can correct the anemia
A. Magnesium
caused by vitamin B12 deficienB. Vitamin D
cy without addressing the neuroC. Vitamin B12
logical damage that this deficienD. Calcium
cy causes. Vitamin B12 deficiency can result in permanent damage to the brain, spinal cord, and
nerves.
92. Which of the following individuals
A. A 25-year-old male who is 6'
would be expected to have the highest tall and weighs 200 pounds; Basal
basal metabolic rate?
metabolic rate for women = 655 +
A. A 25-year-old male who is 6' tall and (4.35 × weight in pounds) + (4.7
weighs 200 pounds
× height in inches) - (4.7 × age
B. A 40-year-old male who is 6' tall and in years). Basal metabolic rate for
weighs 210 pounds
men = 66 + (6.23 × weight in
C. A 30-year-old female who is 5'7" tall pounds) + (12.7 × height in inchand weighs 200 pounds
es) - (6.8 × age in years)
D. A 50-year-old female who is 5'3" tall
and weighs 120 pounds
93. What would be the approximate pro- B. 70; The protein requirement
tein requirement, in grams, for a male, is determined by multiplying the
non-athlete weighing 87 kg?
weight in kilograms by 0.8.
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A. 37
B. 70
C. 239
D. 174
94. It would be appropriate to recomB. has difficulty with portion conmend the use of meal replacements for trol; The Academy's Evidence
weight loss to a client who:
Analysis Library recommends,
A. has no more than 20 pounds to lose. with a strong, conditional rating,
B. has difficulty with portion control. that for people who have difficulty
C. habitually eats late at night.
with self-selection and/or portion
D. does not engage in physical activity. control, meal replacements may
be used as part of the diet component of a comprehensive weight
management program. Substituting one or two daily meals or
snacks with meal replacements
is a successful weight loss and
weight maintenance strategy.
95. What is the physical activity factor
range for "very active"? :
A. 1.9 to less than 2.5
B. 2.6 to less than 3.2
C. 1.6 to less than 1.9
D. 3.3 to less than 3.9
A. 1.9 to less than 2.5; To estimate
total energy needs, multiply resting metabolic rate by physical activity factor. The range for physical
activity factors is sedentary (1.0 or
more to less than 1.4); low active
(1.4 or more to less than 1.6); active (1.6 or more to less than 1.9);
and very active (1.9 or more to
less than 2.5).
96. Why would increasing fortified grain D. The folic acid in fortified grains
intake be recommended to a pregnant helps to prevent neural tube deperson?
fects; Folic acid and folate help
A. Prenatal exposure to grains helps to prevent neural tube defects, so
prevent celiac and gluten sensitivity folate food and fortified foods are
B. Fortified grains help to prevent ges- encouraged in pregnancy. Folate
tational diabetes mellitus
in foods is not sufficient on its own,
C. Fortified grains effectively counter however, and pregnant people are
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pregnancy-related nausea
also encouraged to take a prenaD. The folic acid in fortified grains helps tal vitamin.
to prevent neural tube defects
97. Which of the following foods is consid- B. Graham flour; Graham flour is
ered a whole grain and meets the NSLP considered a whole grain accordstandards for whole grain?
ing to the National School Lunch
A. Pearled barley
Program criteria. All the other
B. Graham flour
items listed have been milled so
C. Hominy
that either the germ or the germ
D. Semolina
and the bran have been removed.
98. What is the minimum number of weekly D. Three-quarter cup; According
servings of red/orange vegetables re- to the NSLP, it is required that chilquired for children in grades K through dren be served ¾ cup red/orange
5 in accordance with the National
vegetables each week.
School Lunch Program reimbursable
lunch?
A. One-quarter cup
B. One-third cup
C. One-half cup
D. Three-quarter cup
99. Which of the following responses
A. "There must be many demands
would demonstrate reflective listen- on your time at home."; Reflective
ing to a client who states: "I don't
listening allows the practitioner to
have time to prepare healthy meals at test a hypothesis of what has been
home"?
heard and involves making stateA. "There must be many demands on ments to confirm understanding of
your time at home."
the client's meaning. Giving adB. "There are many time-saving short- vice is not appropriate in reflective
cuts that I can share with you to help listening.
ease the time crunch."
C. "Everyone is busy, but preparing
healthy meals should be a priority for
you."
D. "That is true for me too, but I know it
is important so I try."
100.
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In what type of diet would docosahexaenoic acid (DHA) supplementation be important?
A. FODMAP
B. Anti-inflammatory
C. Gluten free
D. Vegan
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D. Vegan; DHA is typically absent
in vegan diets, so supplementation may be called for. DHA supplements derived from algae and
thus appropriate for vegans are
available.