RD Exam 2022: Jean Inman Study Guide Domain 2, Part 1

What is cultural competence?

-ability to provide care to pt's with diverse values, beliefs and behaviors.

-tailor delivery to meet social, cultural, and linguistic needs.

RE: Screening Tools

What does SGA stand for?

Subjective Global Assessment

RE: Screening Tools

What does MNA stand for?

Mini Nutritional Assessment

RE: Screening Tools

What does NSI stand for?

Nutrition Screening Initiative

RE: Screening Tools

What does GNRI stand for?

Geriatric Nutritional Risk Index

RE: Screening Tools

What does MST stand for?

Malnutrition Screening Tool

RE: Screening Tools

What does NRS stand for?

Nutrition Risk Screening

RE: Screening Tools

What does MUST stand for?

Malnutrition Universal Screening Tool

T/F:

When a patient conducts a 24 hour recall, underreporting and overreporting are concerns.

True

T/F: the Hamwi formula estimates desirable body weight.

True

RE: Hamwi Formula; medium frame

Females: 100# for the first ____ feet + ____# for each additional [inch/foot].

Males: 106# for the first ___ feet + ____# for each additional [inch/foot]

Females: 5, 5, inch

Males: 5, 6, inch

RE: Hamwi Formula; small frame; both Men and Women

use medium frame formula [-/+] 10%

subtract 10%

RE: Hamwi Formula; large frame; both Men and Women

use medium frame formula [-/+] 10%

add 10%

RE: Hamwi Formula; Amputations; both Men and Women

entire leg: ____%

lower leg with foot: ____%

entire arm: ____%

forearm with hand: ____%

entire leg: 16%

lower leg with foot: 6%

entire arm: 5%

forearm with hand: 2.3%

adjusted IBW: (100-%amputation)/100 x IBW for original height.

RE: Hamwi Formula; Spinal Cord Injury; both Men and Women

quadriplegic: subtract by 10-15% of table weight

paraplegic: subtract 5-10% table weight

learn the term and then use this side to quiz yourself.

What is the BMI of a healthy adult?

18.5-24.9

In regards to physical findings, what does WHR stand for?

a) waist to hip ratio

b) working heart Rate

c) western hemisphere reserve

a)waist to hip ratio

What does WHR differentiate between? (choose the best)

a) waist vs hip sizes to determine health risks

b) android and gynoid obesity

b) android and gynoid obesity

a WHR of ______ in men, ____ in women is indicative of obesity and an increased risk for _________-_________ diseases such as HTN, DM

1.0+, 0.8+, obesity-related

RE: Serum Albumin

levels ABOVE normal range likely d/t [dehydration/rehydration/malnutrition]

dehydration

What is the normal range of creatinine for males and females?

M: 0.6-1.2mg/dl

F: 0.5-1.1 mg/dl

What is a normal range of BUN?

10-20mg/dl

what is the normal range of a BUN to Creatinine ratio?

10-15:1

Regarding lab values: what does TLC stand for and what does it measure?

a) tender love and care, # of heart beats/min

b) total lymphocyte count, immunocompetency

c) T-Boz, Left Eye and Chilli (Shout out to my 90's friends!), number of synapses while listening to 90's hits.

b) total lymphocyte count, immunocompetency

What is a normal range of PT in seconds?

11.0-12.5 seconds

Regarding energy requirements, what is the activity factor for each:

sedentary

active

stressed

sedentary: BEEx1.2

active: BEEx1.3

stressed: BEEx1.5

Megestrol acetate

appetite stimulant

marinol

appetite stimulant

dextroamphetamine/Adderall

appetite suppressant

methylphenidate/Ritalin

anorexia, nausea

statins:

[avoid/increase intake of] grapefruit juice

avoid grapefruit juice

oral contraceptives

[decrease/increase] folate, b6, C

decrease folate, B6, C

loop diuretics

[deplete/retain] thiamin, K+, Mg, Ca, Na

deplete thiamin, K+, Mg, Ca, Na

thiazide diuretics

[decrease/increase] K+, Mg

[decrease/increase] Ca

decrease K+, Mg

increase Ca (absorbs)

Methotrexate

[decrease/increase] folate

Decrease folate

Lithium Carbonate:

- maintain consistent __________ + Caffeine

- antagonizes vitamin ______ (keep intake consistant)

- Avoid ____________ _______________ ______________ (GBE), garlic, and ginger (increases bleeding)

- avoid high doses of Vitamins ___ + ___

-maintain consistent Na & Caffeine

- antagonizes vitamin K (keep intake consistant)

- Avoid ginkgo biloba extract (GBE), garlic, and ginger (increases bleeding)

- avoid high doses of Vitamins A + E

Propofol:

- administered in [oil/sterilized water]; therefore considered as [fat/CHO] calories.

- ______ kcals/ml

-oil, fat

-1.1 kcals/cc

cyclosporine (immunosuppressant)

- what are the 4 "hyper"s this med causes

Hint: hyper-l, hyper-k, hyper-t, hyper-g

HLD

HTN

hyperglycemia

hyperkalemia

isoniazid (treats TB)

- [depletes/reabsorbs] pyridoxine

- [do/don't] take with food

- interferes with [vit A, Mg, Fe / vit D, Ca, P / vit E, RBCs, vit K]

- depletes

- do not

- vit D, Ca, P

Elavil/Amitriptyline

causes one to [lose/gain] weight

gain

Levodopa (Parkinson's)

- vitamin b__ and [PRO/CHO/FAT] decrease effectiveness of drug.

- take med in [AM/PM] with [HI/LOW] PRO meal.

-b6, PRO

-AM, LOW

Levodopa (Parkinson's) should be taken with a LOW PRO meal. About how many grams of PRO should this meal consist of?

~10g

Tyramine + MAOI = ______

a) high BG levels

b) high serum creatinine levels

c) HTN

d) dehydration

c) HTN

curcumin/turmeric may reduce __________________

hint: what tomatoes can cause when consumed in excess.

inflammation

What does HRA stand for?

a) Health Risk Assessment/Appraisal

b) Heart Rising Assessment

c) Hyoid Refusing to Assimilate

a) Health Risk Assessment/Appraisal

What is the HRA?

a survey categorizing a populations general health status

Infant Mortality Rate: infant deaths under ____ year of age

1 year of age

Infant Mortality Rate: # of deaths per ________ live births

a) 100

b) 1000

c) 10,000

b) 1000 live births.

Know the difference between prevalence and incidence.

just an FYI

RE: nutrition assessment of populations and community needs assessment.

what is the definition of incidence?

(number of new cases over a period of time / total # of people @ risk) x 100,000

RE: nutrition assessment of populations and community needs assessment.

what is the definition of prevalence?

(total # of people with a disease during a period of time/average # of people) x 100,000

How to teach depends on the _______ and _______ of the learner.

needs and readiness

What does PPFP stand for?

a) Pastoral and Practical Formation Program

b) Promotion Planning for Professionals

c) Pulp, Paper, and Forest Products

d) Prepared and Perishable Food Programs

d) Prepared and Perishable Food Programs

What are PPFPs?

- [non/for]-profit

-link sources of unused, cooked, and fresh foods with social services agencies that serve the hungry

-non-profit

know the difference between nutritional surveillance and a nutrition survey

just an fyi--

nutrition survey:

- examination of a population group at a particular point of time

- cross-sectional exam

- pin-points problems

-determines [prevalence/incidence] of a condition or characteristic at a specific [place/time]

nutrition survey:

- examination of a population group at a particular point of time

- cross-sectional exam

- pin-points problems

-determines [prevalence] of a condition or characteristic at a specific [time]

Nutritional surveillance:

- [continuous/sporadic] collection of data.

- identifies [problems/shortcuts], sets baseline, sets priorities, detects ___________ in trends.

-uses ht, wt, Hct, Hgb, serum cholesterol

-on-going system linked to active health programs like WIC, CDC

Nutritional surveillance:

- [continuous] collection of data.

- identifies [problems], sets baseline, sets priorities, detects changes in trends.

-uses ht, wt, Hct, Hgb, serum cholesterol

-on-going system linked to active health programs like WIC, CDC

What does WWEIA stand for?

What We Eat in America?

What is WWEIA a component of?

[NHANES/USDA]

NHANES

WWEIA aka:

a) NFNS

b) NFS

c) NSFW

d) NSPA

a) NFNS

RE: NSI (Nutrition Screening Initiative)

T/F: Level II is the RDNs focus because this screen provides more specific diagnostic info on nutritional status.

True

T/F:

BRFSS = behavioral risk factor surveillance system

true

T/F:

YRBSS= Youth Risk behavior Surveillance System

True

T/F:

BRFSS and YRBSS can monitor changes in health risk behaviors over time and can better target health promotion efforts to populations most at risk.

true.

TANF

eligibility determined by [state/federal]

purpose:

eligibility determined by [state]

purpose: help needy families for a limited time to foster economic stability and security

what is the purpose of the USDA commodity food donation/distribution program

-provides foods to help meet nutritional needs of children and adults.

-strengthens agricultural market for products produced by American farmers

CSFP: Commodity Supplemental Food Program

-who administers benefits

-purpose

- state health agencies

- improves health of low-income elderly at least 60 years of age.

NSLP (National School Lunch Program)-

What MUST the lunch provide on average over each school week?

1/3 of the recc intake for PRO, vitamins A&C, Fe, Ca

NSBP National School Breakfast Program

-Umbrellaed under which Federal executive department?

-breakfast MUST provide_____ daily recc intake of PRO, Ca, Fe, Vit A&C

-USDA

-1/4

ASP Afterschool Snack Programs:

-Umbrellaed under which Federal executive department?

-purpose

-USDA

-purpose: provides healthy snacks.

SMP (Special Milk Program)

-Umbrellaed under which Federal executive department?

-T/F: it is an entitlement program

-USDA

-True

SFSP: Summer Food Service Program

-Umbrellaed under which Federal executive department?

-T/F: it is an entitlement program

-USDA

-True

CACFP: Child & Adult Care Food Program

-Umbrellaed under which Federal executive department?

-purpose

-t/f: it's a reimbursement program

-USDA

- supports public and non-profit food service programs for day-cares (kids and adults), neighborhood housing, homeless shelters

- true: it is a reimbursement program.

FFVP (Fresh Fruit and Vegetable Program)

-Umbrellaed under which Federal executive department?

- purpose

-USDA

-improve health, prevent obesity.

WIC (women, infants, and children)

-Umbrellaed under which Federal executive department?

- T/F: health exam is required and EBT card needed

-USDA

- True

EFNEP (Expanded Food and Nutrition Education Program)

-Umbrellaed under which Federal executive department?

-[Does/Does not] provide food

- T/F: works with small groups; teaches skills needed to obtain a healthy diet (budget, meal planning, shop, cook)

- USDA

- True

- True

Maternal and Child health Block Grant

-Umbrellaed under which Federal executive department?

-serves which 3 population age groups, [state/federal] eligibility requirements.

- USDHHS

- women of child bearing age, infants, & children; state eligibility req's

Healthy Start

-Umbrellaed under which Federal executive department?

- T/F: reduces infant mortality

- USDHHS

-True

RE: Community Programs

What does AOA stand for?

a) aware of aging

b) administration on aging

c) administration of atherosclerosis

b) Administration on Aging

What does OAA stand for?

Older Americans Act

What was OAA formerly called?

ENP

OAA: eligibility age, [plus/without] spouse,

t/f: regardless of income

60+yo

plus spouse

true- regardless of income :)

SNAP- Supplemental Nutrition Assistance Program

do you need an EBT card?

yes, an EBT card is needed to receive the benefits.

Headstart program

-Umbrellaed under which Federal executive department?

- purpose

- is the child's participation in food activities important?

- USDHHS

- purpose: teaches good food habits

- yes!

NETP- Nutrition Education and Training Program

-Umbrellaed under which Federal executive department?

-purpose

-USDA

-provides Nutrition Ed training to teachers and school food service personnel.

SFMNP Senior Farmers Market Nutrition Program

-Umbrellaed under which Federal executive department?

-purpose

- USDA

-provides cash grants to states to provide low-income seniors to be exchanged for eligible foods at farmers markets, road stands, and CSAs

-includes herbs and honey

Which non-governmental agency is the largest domestic hunger relief organization in the US that includes soup kitchens, shelters, and food banks?

a) Feeding America

b) SNAP

c) WIC

a) Feeding America

RE: Evaluating a PES Statement.

if you have 2 dx's from 2 different domains, which dx should be used to be more specific to the nutrition professional?

a) Clinical

b) intake

c) behavioral

b) intake

Note: More likely to facilitate a nutrition-directed intervention

in EMR's: should you change your co-workers entry AND your own entry, or JUST your own entry only?

JUST YOUR OWN ENTRY ONLY!

RE: MNT --> GI Disorders --> Ulcers

-treatment

-diet

-tx: antacids, abx to eradicate H. Pylori

-diet: as tolerated by pt, well balanced, avoid late night snacks

RE: MNT --> GI Disorders --> Hiatal Hernia

- diet

diet: small bland feedings; avoid late night snacks

RE: MNT --> GI Disorders --> Dumping Syndrome

T/F: this is a reactive or alimentary hypoglycemia

True

RE: MNT --> GI Disorders --> Dumping Syndrome--> Billroth II gastric Surgery.

[Ca/Vitamin A] (most rapid absorption in the duodenum) and _____ absorption (requires acid) are adversely affected.

Calcium

Fe

RE: MNT --> GI Disorders --> Dumping Syndrome--> Anemia

Which type of test is used to dx pernicious anemia?

a) H+ test

b) Schilling test

c) BG test

d) 24 hour recall

b) Schilling test

*Looking for intrinsic factor

According to Jean Inman:

following a complete gastrectomy, deficiencies of which 7 vits/mins may develop?

bbccdff

B1

B12

Ca

Cu

Vitamin D

Fe

Folate

RE: MNT --> GI Disorders -->Tropical Sprue (bacterial, viral, parasitic infection)

-s/s include diarrhea, malnutrition, B__, folate d/t decreased _______ and intrinsic factor

- tx

- B12, HCl

- abx, high cals, high PRO, IM b12 and PO folate

RE: MNT --> GI Disorders -->Non-Tropical Sprue

diet

-diet: gluten-restricted

RE: MNT --> GI Disorders --> Diverticular Disease

diet

high fiber diet

RE: MNT --> GI Disorders --> Diverticular Disease --> Fiber

oat bran and soluble fibers decrease serum __________ by binding bile acids converting more ____________ into bile

cholesterol

RE: MNT --> GI Disorders --> Diverticular Disease --> Fiber

soluble fibers = P__________ & G_____

pectins and gums