A patient with a long history of heavy alcohol use is admitted with confusion, unsteady gait and abnormal eye movements. Deficiency of which vitamin is the most likely cause?
Thiamin Confusion, ataxia and eye-movement problems are the classic signs of Wernicke encephalopathy, which is caused by thiamin (vitamin B1) deficiency. Heavy alcohol use lowers thiamin intake, absorption and storage, so thiamin is given before glucose in these patients.
How many kilocalories does 1 gram of alcohol (ethanol) provide?
7 kcal Alcohol provides about 7 kcal per gram. Carbohydrate and protein provide 4 kcal per gram, and fat provides 9.
A vegetarian client wants to absorb more iron from beans and spinach. Which change to the same meal would help most?
Add a food rich in vitamin C, such as bell peppers Plant foods contain nonheme iron, and vitamin C eaten in the same meal increases its absorption. Tea (polyphenols), calcium and bran (phytates) all reduce nonheme iron absorption.
A dietitian wants to find out whether a new counseling program causes lower HbA1c than usual care. Which study design gives the strongest evidence of cause and effect?
Randomized controlled trial In a randomized controlled trial, participants are randomly assigned to the program or usual care, so the groups are alike except for the intervention. That makes it the strongest single-study design for showing cause and effect.
An adult weighs 70 kg and is 1.75 m tall. What is the BMI?
22.9 kg/m² BMI is weight in kilograms divided by height in meters squared. 1.75 × 1.75 = 3.06, and 70 ÷ 3.06 = 22.9 kg/m², which is in the healthy weight range of 18.5 to 24.9.
A patient’s usual weight is 80 kg. Three months later, without trying, they weigh 72 kg. What percentage of usual body weight have they lost?
10% Percent weight loss = (usual weight − current weight) ÷ usual weight × 100. That’s (80 − 72) ÷ 80 × 100 = 10%. An unintentional loss this large over 3 months is significant and needs a closer look for malnutrition.
Using the Hamwi method, what is the ideal body weight for a woman who is 5 feet 4 inches tall?
120 lb The Hamwi method for women gives 100 lb for the first 5 feet plus 5 lb for each inch over 5 feet. That’s 100 + (4 × 5) = 120 lb.
In the Nutrition Care Process, a PES statement links the nutrition problem and its etiology to which third element?
The signs and symptoms that show the problem exists PES stands for Problem, Etiology and Signs/Symptoms. The signs and symptoms are the assessment data that show the nutrition problem is really there, written after “as evidenced by.”
A patient is starting long-term warfarin. What is the best advice about vitamin K?
Keep vitamin K intake consistent from day to day Warfarin works by blocking vitamin K-dependent clotting factors, so big swings in vitamin K intake change how well it works. The goal is a steady, consistent intake, so the dose can be set around the patient’s normal diet.
Which grain is naturally gluten free and safe for a person with celiac disease, provided it isn’t cross-contaminated?
Rice Rice is naturally gluten free. Barley, rye and spelt (a type of wheat) all contain gluten proteins that trigger the immune reaction in celiac disease.
A child with phenylketonuria (PKU) should avoid foods and drinks sweetened with which sweetener?
Aspartame Aspartame is made from phenylalanine and aspartic acid, so it adds phenylalanine to the diet. People with PKU can’t break down phenylalanine, which is why products with aspartame carry a phenylketonurics warning.
Compared with a patient who has stage 4 chronic kidney disease and isn’t on dialysis, a patient on maintenance hemodialysis usually needs:
More protein, because dialysis removes amino acids Before dialysis, protein is limited to slow kidney damage. Once a patient starts hemodialysis, amino acids are lost during treatments and protein needs go up, so the diet changes to a higher protein intake.
A severely malnourished patient is starting tube feeding. Which lab finding is the hallmark of refeeding syndrome?
Low serum phosphorus When feeding restarts, insulin rises and drives phosphorus, potassium and magnesium into cells. Low serum phosphorus (hypophosphatemia) is the hallmark. That’s why feeding starts slowly and these electrolytes are checked closely.
One full-time equivalent (FTE) is 40 hours a week. A foodservice department has an employee who works 20 hours a week. How many FTEs is that position?
0.5 FTE FTE = hours worked ÷ full-time hours. 20 ÷ 40 = 0.5 FTE. Over a year, 1.0 FTE is 2,080 paid hours (40 × 52).
A café spent $3,000 on food last month and had $10,000 in food sales. What is its food cost percentage?
30% Food cost percentage = food cost ÷ food sales × 100. $3,000 ÷ $10,000 × 100 = 30%.
A clinical nutrition manager compares the number of patients actually assessed within 24 hours with the department’s standard and then takes corrective action. Which management function is this?
Controlling Controlling means setting standards, measuring actual performance, comparing the two and correcting any gap. That’s exactly what the manager is doing here.
A hospital team tests a new tray-delivery process on one unit for two weeks before using it everywhere. In the Plan-Do-Check-Act (PDCA) cycle, the two-week trial is which step?
Do In PDCA, Do means carrying out the change on a small scale to test it. The team will then Check the results and Act by adopting, adjusting or dropping the change.
A recipe needs 20 lb of cleaned, peeled carrots (edible portion). The yield for carrots is 80%. How many pounds should be purchased (as purchased)?
25 lb As-purchased amount = edible portion needed ÷ yield. 20 lb ÷ 0.80 = 25 lb. After trimming and peeling, 80% of 25 lb leaves the 20 lb the recipe needs.
Under the FDA Food Code, hot time/temperature control for safety (TCS) foods on a serving line must be held at what internal temperature or higher?
135°F (57°C) The FDA Food Code requires hot-held TCS food to stay at 135°F (57°C) or above. Between 41°F and 135°F is the temperature danger zone, where bacteria grow quickly.
Under the FDA Food Code, cooked TCS food must be cooled from 135°F to 70°F within how many hours?
2 hours Cooked food must cool from 135°F to 70°F within 2 hours, and from 135°F to 41°F or below within 6 hours total. The first stage is the fastest because bacteria grow best in that range.
United States · Exam