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Name the normal values for fecal fat, serum sodium, and hemoglobin A1c.
- Fecal fat = 5 - 7 htsmd/24 hours
- Sodium = 135 - 148 mEq/L
- Hemoglobin A1c = 4.0 - 8.2% (3-4 month test to evaluate blood glucose)
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Name the affected blood lab values in pernicious anemia
- Low RBC, Hgb, Hct
- High MCV
- Normal MCHC
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Name the nutrient needs that increase during lactation.
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Name the affected blood lab values in iron deficiency anemia.
- Low Hgb, Hct, MCV and MCHC
- RBC may be normal
- (Microcytic anemia)
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Describe the feeding regimen for a breast-fed infant
On demand
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Name the half-life of transferring and the normal storage capacity
- Half-life = 8-10 days
- Normally saturated 30 - 40% with iron
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Name the onset time of regular, NPH, and ultralente insulin.
- Regular = 0.5 - 1 hour
- NPH = 2 - 4 hours
- Ultralente = 6 - 10 hours
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A TPN solution contains: 500 ml 20% dextrose, 500% ml 4% protein, 250 ml 20% dextrose, 500 ml 4% protein, 250 ml 20% lipids. Determine the non-protein kcals, total kcals and non-protein kcals: nitrogen ration.
- 840 non-protein kcals
- 920 total kcals
- 263:1 ratio
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What is the kcal:N ratio of 1500 kcals and 20% protein?
125:1 ratio
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A patient is receiving 2 liters of D5W; how many kcals would this provide?
340 kcals
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Define colostrum
It is the milk that is produced just prior to and after childbirth, it is rich in antibodies.
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Name the only circumstance when it is advised for pregnant women to lose weight.
- Never.
- "if a pregnant women is overweight, the dietitian wants to council the patient on how to slow the rate of weight gain, but never to lose weight"
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How much formula and water is needed for 3/4 strength tube feeding at 50 cc/hour for 24 hours?
- 900 cc/day of formula
- 300 cc water
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Name the first step when developing an inservice, presentation, or workshop.
Assess the needs and interests of the audience.
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Nutrition education programs should primarily be used as:
Change agents
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A pregnant vegan's diet may lack which nutrients?
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Describe the objective of HMOs.
HMOs focus on preventative medical care, the main objective is to prevent patients from being admitted to the hospital.
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Compare the fat, protein, and CHO content in 1 L of human breast milk to that of formula.
- Human milk contains 45 gms fat, 9-11 gms protein, and 70 gms CHO
- Formula contains 33-36 gms fat, 15 gms protein, and 79-96 gms of CHO
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Describe the appropriate rate of weight gain during pregnancy.
- Weight gain is slow during the 1st trimester and increases in the 2nd and 3rd trimesters.
- "recommended weight gain: 2-4 lbs in the 1st trimester; 1 pound/wk in the 2nd and 3rd trimesters.
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List the most common reasons for weight gain amongst the US adult population.
- Sedentary lifestyle
- Overeating
- Modern day conveniences replacing energy expending activities
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Name the most effective tool for assessing the nutritional status of the elderly population.
Height and weight
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List three common nutritionally related disease states among the elderly.
- Obesity
- Osteoporosis
- High blood pressure
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Define morbidity and mortality.
- Morbidity is the incidence of illness
- Mortality is the incidence of death
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What does the RD need first to release patient record to a physician
Written consent from the patient
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Name the NHANES population surveyed
2 months to 74 years
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List the two most common nutrients that are supplemented during pregnancy.
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List three considerations when planning a nutrition program for the elderly.
- Transportation
- Food myths
- Lack of exercise
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A 155-pound, 5'10" male is what percentage of his IBW?
93.3% of his IBW
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What is a neutropenic diet?
A low bacteria diet, fresh fruits and vegetables are omitted.
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Name the criteria for the Congregate Meals program.
- 60 years or older
- No income criteria
- Only one member of a couple must qualify
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What foods are in alkaline ash diet?
Fruits and vegetables
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Explain positive and negative nitrogen balance.
- Positive nitrogen balance = greater retention than excretion (times of building and healing)
- Negative nitrogen balance = greater excretion than retention (times of sickness)
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Name the most important anthropometric indicator of failure to thrive.
Weight for age
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Define regulation
A regulation is the interpretation of a law
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Name the disease that alters copper metabolism
Wilson's Disease
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Name the report that provides information for the formulation of the "10 Leading Causes of Death in the US"
- The Surgeon General's report
- "Heart disease, stroke, and cancer are the top 3 causes of death in this country, and dietary factors play a role in each"
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Describe the growth pattern seen in growth retardation.
- As age increases, increments of linear growth are slowed.
- "That is, when plotted on growth charts, height for age decreases slowly overtime"
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The Child and Adult Care Food Program serves what population?
Children and adults in day care facilities.
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Name the purpose of the Dietary Guidelines.
- To prevent chronic disease
- They also aid in planning for community nutrition programs
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An HIV patient has a consistent temperature of 104 degrees F. What percentage increase would be in the kcals needed to maintain body weight?
37.8%
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A tube feeder with 1.6 kcals/cc is to run from 10pm - 11am. What rate is needed to deliver 1800 kcals/24 hours?
86.5 cc/hour
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List general goals of a community based nutrition program.
- Meet the needs of the large demographic group within a population.
- Address the communities' largest problems.
- Take into consideration the goals of the local government and public officials
- "A goal would NOT include meeting ALL the needs of the community"
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When would you contact your congressional representative to gain support in a piece of legislation?
After the bill has been introduced to the floor.
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Reading the local newspaper will inform you on what stage of the passage of a bill?
The proposal stage.
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Define Appropriation Bill
A bill that request government funding for a community based program.
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Name the population that has an increased incidence of obesity.
African-American females age 44-65
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What daily caloric intake will result in weight loss of 2 lbs/month if currently consuming 2000 kcals/day?
1750 kcals/day
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Name the food restrictions in Judaism.
- No pork products
- Fish must have fins/scales such as cod or halibut. (No shellfish, squid, etc)
- No meat/poultry or dairy combined in the same meal (i.e. Pepperoni Pizza)
- No foods containing blood.
- "Note that gelatin contains pork products"
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Name the first step involved when making program changes due to funding cuts.
Reassess program
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Compare surveys with surveillance programs
- Surveys are conducted once in a given timeframe.
- A surveillance program is ongoing or continuous.
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List some frequently eaten foods by the Native American population
- A variety of meats, nuts, berries, corn, jerky, maple syrup, tomatoes and squash.
- "There is a high prevalence of lactose intolerance in this population."
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What foods are in the acid ash diet?
Cereals and meats.
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Name normal hemoglobin and hematocrit values.
- Hematocrit: Men = >44%; Women = >38%
- Hemoglobin: Men = 14.0 or greater; Women = 12.0 or greater
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Name the preparation process that contributes to the most vitamin loss.
Chopping and cutting of foods into small pieces
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Name some symptoms of vitamin A deficiency.
- Keratinization of the skin and mucous membranes.
- Night blindness
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Name the active form of vitamin D.
1,25-dihydroxycholecalciferol (calcitriol)
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Describe the conversion of tryptophan to niacin.
- 60 mg tryptophan yields 1 mg niacin.
- "If protein or tryptophan intake increases, then there is decreased need for intake of niacin."
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Describe how antibiotics can cause vitamin K deficiency.
High doses of antibiotics can destroy the intestinal flora which synthesizes intrinsic factor causing a decrease synthesis of vitamin K.
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Name the best sources for vitamin K.
Leafy green vegetables; i.e. broccoli, cabbage, turnip greens, lettuce
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Name some anticoagulants and their role with vitamin K.
- Coumadin, Warfarin, Heparin: Act as vitamin K antagonists.
- "While on these medications, it is important to keep a consistent intake of vitamin K."
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Name the required nutrients on a food label aside from the energy producing nutrients.
- Sodium, vitamin A, vitamin C, calcium, and iron.
- "Vitamin A, vitamin C, calcium, and iron are the most common deficient nutrients in the US diet."
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Name the B-complex vitamins.
- B1 = Thiamin
- B2 = Riboflavin
- B3 = Niacin
- B6 = Pyrodoxine
- B12 = Cobalamin
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Describe glutathione peroxidase.
- Active form of selenium that acts with antioxidants
- "There is a risk of selenium deficiency in TPN patients without supplementation"
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Name the structure that closely resembles glucose.
Vitamin C (ascorbic acid)
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Define osteoblast.
Cell that forms bone structure
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Define osteoclast.
Cell that breaks down bone structure.
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How many kcals in 2 pieces of bread and 2 ounces of turkey breast
236 kcals
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Describe beta carotene
A precursor to vitamin A, converted in the small intestine.
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Describe Wilson's Disease
- Excessive accumulation of copper in the liver, brain, kidney, and cornea.
- An inherited disorder of copper metabolism.
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What role does estrogen play in bone loss.
Estrogen decreases resorption of calcium from the bone.
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Describe the Glucostatic theory.
Signals are sent to they hypothalamus indicating to the brain that satiety has been reached.
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Describe phytic acid.
Found in husks of cereal grain, binds with calcium and inhibits absorption.
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Name some influences on iron absorption.
- Citrus juices increase iron absorption.
- Tea, coffee, and milk decrease absorption.
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Name the major function of folate.
- Transport single carbon fragments in amino acid metabolism and nucleic synthesis.
- "Essential to cell division and red blood cell formation."
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Describe the role of vitamin E.
- Acts as an antioxidant
- Enhances activity of vitamin A
- Prevents peroxidation of polyunsaturated fatty acids
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Name some of the effects of zinc deficiency.
- Loss of taste (hypogeusia)
- Loss of smell (hyposmia)
- Poor wound healing
- Short stature and development disorder in growth and reproduction
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