560E ASSESMENT IN NUTRITION Flashcards
(190 cards)
1
Q
A sensitive assessment of folate status is:
a. urinary formiminoglutamic acid (FIGLU).
b. urinary methylmalonic acid (MMA).
c. urinary beta-hydroxybutyric acid.
d. urinary homovanillic acid.
A
A
2
Q
Elevated fecal lactoferrin would most likely be observed in
a. ulcerative colitis.
b. GERD.
c. irritable bowel syndrome.
d. lactose intolerance.
A
A
3
Q
Which of the following techniques would not be considered an effective method for measuring dietary intake? A. 24-hour recall B. Food diary C. Diet history d. Estimation based on weight
A
D
4
Q
Which of the following is true regarding the 24-hour recall?
A. Because it relies on a person’s memory, it is highly accurate.
B. One 24-hour period is highly representative of an individual’s usually intake.
C. Underreporting and/or overreporting can occur.
D. It is difficult and time-consuming to administer.
A
C. underreporting and/or overreporting can occur.
5
Q
An advantage of the Food Record over the 24-hour Recall is?
A. Does not depend on memory
B. Quicker to obtain data
C. Does not alter usual diet
A
A. does not depend on memory
6
Q
A strength of the Diet History is
A. That it is the quickest method for evaluating nutrient intake.
B. That is can be done by untrained interviewers.
C. That it assesses usual nutrient intake.
D. Is the least expensive method to employ.
A
C that it assesses usual nutrient intake.
7
Q
A well-known biological marker for verifying reported protein intake is
A. Analysis of nitrogen in hair
B. Analysis of sulfur in a 24-hour urine specimen.
C. Analysis of nitrogen in a 24-hour urine specimen.
D. Analysis of sulfur in hair.
A
C analysis of nitrogen in a 24-hour urine specimen.
8
Q
An accurate dietary assessment can be the sole criterion on which to base nutritional recommendations for an individual.
A. True
B. False
A
false
9
Q
One of the most difficult nutrient values to assess accurately when examining intake data A. Total energy intake B. Protein intake C. Vitamin A intake D. Sodium intake
A
C vitamin A intake
10
Q
Most high-quality computerized dietary analysis systems contain food composition data from A. The USDA SR only. B. USDA sources only. C. USDA plus non-USDA sources. D. Food manufacturers only.
A
C USDA plus non-USDA sources
11
Q
The generally accepted normal range for BMI is A. 12.5-18.9 B. 18.5-24.9 C. 24.5-30.9 D. 30.5-34.9
A
B 18.5-24.9
12
Q
A waist circumference of 38 inches in an adult female
A. Indicates gynoid obesity
B. Indicates a normal weight.
C. Indicates an increased risk for type 2 diabetes.
D. Indicates a normal BMI.
A
C indicates an increased risk for type 2 diabetes.
13
Q
A disadvantage of assessing weight with BMI is that
A. Measuring BMI requires skill and time.
B. BMI can be elevated for reasons other than excess fat.
C. Measuring BMI is invasive to the patient.
D. Special equipment is needed.
A
B BMI can be elevated for reasons other than excess fat.
14
Q
A triceps skin fold measures A. Muscle mass. B. Muscle mass and subcutaneous fat. C. Subcutaneous fat. D. Muscle mass, subcutaneous fat, and bone tissue.
A
C subcutaneous fat.
15
Q
A disadvantage of Bioelectrical Impedance is
A. Electrical current is transmitted most rapidly by fat.
B. Dehydration will overestimate fat mass.
C. Is invasive to the patient.
D. Is a slow procedure.
A
dehydration will overestimate fat mass.
16
Q
3 factors that contribute to total energy expenditure are
A. BMR, physical activity, thermic effect of food.
B. BMR, REE, physical activity.
C. BMR, REE, adaptive thermogenesis.
D. BMR, RMR, physical activity.
A
A BMR, physical activity, thermic effect of food.
17
Q
Basal Metabolic Rate is most closely related to A. Amount of body fat. B. Amount of total bone mass. C. Amount of lean body mass. D. Amount of exercise.
A
C. amount of lean body mass.
18
Q
Determination of body density by under-water weighing allows estimation of A. BMR. B. Bone mass. C. BMI. D. Body fat.
A
D. body fat.
19
Q
According to the guidelines for treating obesity developed by the NHLBI, ideal rate of weight loss should be
A. 0.5 to 1 pound per week attained through a caloric deficit of 500 to 1000 kcals per day.
B. 1 to 2 pounds per week attained through a caloric deficit of 500 to 1000 kcals per day.
C. 2 to 3 pounds per week attained through a caloric deficit of 1000 to 1500 kcals per day.
D. 1 to 2 pounds per week attained through a caloric deficit of 100 to 200 kcals per day.
A
B. 1 to 2 pounds per week attained through a caloric deficit of 500 to 1000 kcals per day.
20
Q
Which of the following laboratory tests would not be a reasonable part of initial assessment of the obese patient? A. Lipid profile. B. Thyroid function test. C. Fasting blood glucose D. Serum calcium measurement
A
D. serum calcium measurement
21
Q
Clinical findings are extremely important in nutritional assessment because, when present, they are specific for a particular nutrient deficiency.
A. True
B. False
A
B false
22
Q
The most probable cause of edema in an individual would be A. Calcium deficiency. B. Vitamin A deficiency. C. Vitamin C deficiency. D. Protein deficiency.
A
D protein deficiency.
23
Q
A decrease in taste sensation would most likely indicate a deficiency of A. Zinc. B. Protein. C. Vitamin C. D. Vitamin K.
A
zinc.
24
Q
During a medical history, Martha indicates that she is a vegan and that she does not take supplements because she cannot swallow pills. What would be the most likely nutrient deficiency for her to have? A. Vitamin C. B. Vitamin B12. C. Folic acid. D. Magnesium
A
vitamin B12
25
```
The presence of muscle wasting is best assessed by examination of
A. Abdominal muscles.
B. Triceps muscles.
C. Deltoid muscles.
D. Pectoral muscles.
```
deltoid muscles.
26
Which of the following would not be an indication of bulimia?
A. Eating small amounts of food several times a day.
B. Eating a very large amount of food in a discrete period of time.
C. Dental erosion.
D. Asymmetrical parotid gland enlargement.
eating small amounts of food several times a day
27
```
Which one of the following is a type of lipodystrophy sometimes seen in patients with Cushing's syndrome?
A. Moon face.
B. Old man's face.
C. Flag sign.
D. Stomatitis.
```
moon face
28
```
Profound physical wasting and malnutrition usually associated with chronic disease and advanced acquired immune deficiency syndrome is known as __________.
A. Stunting.
B. Lipohypertrophy
C. Cachexia
D. Edema
```
cachexia
29
```
The _________ are frequently the first regions of the body to show signs indicative of a vitamin deficiency.
A. Eyes and ears.
B. Tongue and oral cavity.
C. Arms and legs.
D. Heart and lungs.
```
tongue and oral cavity
30
```
The most likely nutrient deficiency to be observed in an alcoholic is vitamin
A. Vitamin B12.
B. Fat.
C. Iron.
C. Thiamin.
```
thiamin.
31
```
Urine is primarily
A. Urea.
B. Uric acid.
C. Water.
D. Solute.
```
water.
32
Which of the following would be expected to decrease the pH of urine?
A. Allowing the specimen to sit for several hours at room temperature.
B. Ingesting large quantities of meat.
C. Ingesting large quantities of fruits and vegetables.
D. Ingesting antacids
B ingesting large quantities of meat
33
```
The most sensitive indicator of kidney malfunction is
A. Specific gravity.
B. Nitrites.
C. Crystals.
D. Protein.
```
D protein.
34
```
Ketonuria would be most likely found in
A. A dilute urine.
B. An individual on the Atkins diet.
C. An individual with renal disease.
D. An individual with well-controlled Type II diabetes.
```
B an individual on the Atkins diet.
35
Ketonuria would be most likely found in a dilute urine.
A. A dilute urine.
B. An individual on the Atkins diet.
C. An individual with renal disease.
D. An individual with well-controlled Type II diabetes.
an individual on the Atkins diet.
36
```
Microscopic exam of urine sediment provides the most useful information about
A. The urinary system.
B. Metabolic acidosis
C. Dietary intake.
D. Recent drug use.
```
the urinary system.
37
What would be considered the most ominous finding in a urinalysis report?
A. Moderate number of uric acid crystals.
B. Few white blood cells.
C. Occasional epithelial cells
D. Moderate number of waxy casts
moderate number of waxy casts
38
```
Urine that is pale and nearly colorless would be most likely observed
A. In a first morning specimen.
B. When glucose is positive.
C. When bilirubin is positive.
D. When leukocyte esterase is positive.
```
when glucose is positive.
39
```
An elevated betahydroxyisovalerate in urine would indicate a need for supplementation with
A. Biotin.
B. Iron.
C. Vitamin C.
D. Essential fatty acids.
```
A biotin
40
```
The only positive finding on a urinalysis of a 25-year-old female is the observation of red blood cells. What is the most likely cause?
A. Lab error.
B. Urinary tract infection.
C. Menstruation.
D. Renal tumor.
```
menstruation
41
```
In which area has urinary organic acid assessment been the most useful?
A. Diagnosing cancer.
B. Detecting a kidney infection.
C. Confirming a heart attack
D. Detecting free radical overload
```
detecting free radical overload
42
Which of the following is true about serum albumin levels?
A. Short half-life allows for rapid response to nutritional changes.
B. Protein status is the only factor that affects serum concentration.
C. Must be measured in the fasting state.
D. Dehydration results in increased serum concentration.
Dehydration results in increased serum concentration.
43
```
What is the most likely explanation for a low level of tryptophan in a blood specimen?
A. Toxicity from chemicals.
B. Inadequate stomach acid.
C. Steroid use.
D. Vitamin B6 deficiency.
```
inadequate stomach acid
44
```
Plasma tyrosine has been proposed as a useful assessment of
A. Kidney function.
B. Thyroid function.
C. Detoxification.
D. Muscle catabolism.
```
thyroid function.
45
When choosing the specimen type for amino acid profiling, an appropriate guideline is:
A. Urine is the preferred specimen to indicate nutrient demands.
B. Plasma is always the preferred specimen to assess amino acid metabolism.
C. Plasma is the preferred specimen when the prime consideration is the supply of the essential amino acids for optimum balance to maintain or restore health.
D. The same information can be obtained from both urine and plasma specimens.
C Plasma is the preferred specimen when the prime consideration is the supply of the essential amino acids for optimum balance to maintain or restore health.
46
```
An appropriate assessment for muscle mass is
A. Urinary excretion of albumin.
B. Urinary excretion of creatinine.
C. Urinary excretion of ketones.
D. Urinary excretion of urea
```
urinary excretion of creatinine.
47
```
A catabolic state would produce
A. Negative nitrogen balance.
B. Positive nitrogen balance.
C. Nitrogen equilibrium.
D. No effect on nitrogen balance.
```
A a negative nitrogen balance.
48
```
Excretion of ____________ provides an indicator of
A. Glucose.
B. Methionine.
C. Methylhistidine.
D. 3-methylhistidine
```
3-methylhistidine
49
```
Increased blood pressure would be most likely observed with decreased levels of
A. Arginine.
B. Glycine.
C. Phenylalanine.
D. Glutamine.
```
A arginine.
50
```
As a cofactor for several digestive enzymes, a deficiency of this element can affect overall plasma amino acid levels:
A. Iodine.
B. Sodium.
C. Potassium.
D. Zinc
```
D zinc
51
```
An example of a somatic protein is
A. Collagen in cartilage.
B. Albumin in plasma.
C. Myosin in skeletal muscle.
D. Antibodies in the bloodstream.
```
C myosin in skeletal muscle
52
```
An increase in expired hydrogen after an oral dose of lactose indicates
A. Lack of pancreatic lipase.
B. Lack of intrinsic factor.
C. Lack of intestinal lactase.
D. Lack of intestinal peptidase.
```
C a lack of intestinal lactase.
53
```
Gastric colonization with ________________ is strongly correlated with duodenal and gastric ulcers.
A. E. coli.
B. Staph aureus.
C. Helicobacter pylori.
D. Bifidus regularis.
```
C Helicobacter pylori
54
Bacterial overgrowth in the small intestine could be diagnosed by
A. Bacterial count of at least 103/ml in an intestinal fluid aspirate.
B. Achlorhydria.
C. Positive AGA antibodies.
D. Excess exhalation of 14CO2 after an oral dose of 14C-xylose.
D excess exhalation of 14CO2 after an oral dose of 14C-xylose.
55
```
Bacterial fermentation in the large intestine produces
A. Beneficial glycoproteins.
B. Pectins.
C. Short-chain fatty acids.
D. Branched-chain amino acids.
```
C. Short-chain fatty acids.
56
```
Which symptom would be least likely to occur in an individual with malabsorption?
A. Steatorrhea
B. Weight loss
C. Weight gain
D. Anemia
```
C weight gain
57
```
The most common test used to confirm malabsorption assesses
A. Serum gastrin.
B. Fecal fat.
C. Exhaled hydrogen.
D. Serum B12.
```
B fecal fat.
58
Medium-chain triglycerides (MCTs) can be helpful in nourishing those with inflammatory bowel disease because
A. MCTs are absorbed through the stomach.
B. MCTs are absorbed directly into portal blood.
C. MCTs reach the lymphatic system rapidly.
D. MCTs are prebiotics.
B MCTs are absorbed directly into portal blood.
59
```
A decreased fecal elastase is most strongly correlated with
A. Celiac disease.
B. Lactose intolerance.
C. Pernicious anemia.
D. Pancreatic insufficiency.
```
D pancreatic insufficiency.
60
```
A positive anti-gliadin antibody (AGA) and anti-endomysial antibody (EMA) are nearly 100% diagnostic of
A. Bacterial overgrowth.
B. Celiac disease.
C. Crohn's disease.
D. Zollinger-Ellison syndrome.
```
B celiac disease.
61
Consistent blood glucose control in diabetes
A. Delays the onset and slows the progression of complications.
B. Primarily appropriate for Type 1 diabetes.
C. Offers no advantage over less stringent control in terms of delaying or slowing complications.
D. Primarily appropriate for Type 2 diabetes.
A delays the onset and slows the progression of complications.
62
Autoantibodies are most commonly associated with type 1 diabetes.
A. True
B. False
A true
63
The best screening test for diabetes is measurement of
A. Urine glucose.
B. Measurement of fasting plasma glucose.
C. 5 hour glucose tolerance test.
D. Measurement of urine ketones.
B measurement of fasting plasma glucose.
64
```
A fasting plasma glucose value greater than 100 mg/dl, but less than 126 mg/dl indicates
A. Normal blood glucose.
B. Type 1 diabetes.
C. Type 2 diabetes.
D. Impaired fasting glucose.
```
D impaired fasting glucose.
65
The major benefit of measuring glycosylated hemoglobin is
A. Gives information about glucose levels at the precise moment the blood specimen is drawn.
B. Is only elevated in Type 1 diabetes.
C. Reflects average blood glucose levels during the past 8 to 12 weeks.
D. Is only elevated in Metabolic Syndrome.
C
66
Nutritional recommendations for individuals with diabetes
A. Follow strict guidelines developed by the American Diabetes Association.
B. Should include a large amount of simple sugar to prevent hypoglycemia during treatment.
C. Should exclude all simple carbohydrates from the diet.
D. Should be based on nutritional assessment of each individual.
D should be based on nutritional assessment of each individual.
67
A BMI greater than 25 would most likely be observed in a
A. Type 1 diabetic.
B. Type 2 diabetic.
C. In all diabetics.
D. When fasting plasma glucose levels are greater than 200 mg/dl.
B in a Type 2 diabetic.
68
```
Ketosis is more likely to be observed
A. In a Type 1 diabetic.
B. In a Type 2 diabetic.
C. In Syndrome X.
D. When glycosylated hemoglobin is below 7%.
```
A in a Type 1 diabetic.
69
```
The lack of insulin in Type 1 diabetes is associated with all of the following except
A. Increased protein catabolism.
B. Glycosuria.
C. Increased glucose use.
D. Dehydration.
```
C increased glucose use.
70
```
Which of the following glucose values would result in a diagnosis of gestational diabetes mellitus when measured as part of a 75-g oral glucose tolerance test (OGTT)?
A. Fasting blood glucose of 90 mg/dl
B. Fasting blood glucose of 106 mg/dl
C. 1 hour glucose of 178 mg/dl
D. 2 hour glucose of 150 mg/dl
```
B fasting blood glucose of 106 mg/dl
71
The Healthy Eating Plate developed by the Harvard School of Public Health differs from the USDA MyPlate in that
A. The Healthy Eating Plate recommends more dairy.
B. The Healthy Eating Plate recommends fewer vegetables.
C. The Healthy Eating Plate recommends more protein.
D. The Healthy Eating Plate emphasizes healthy oils.
D the Healthy Eating Plate emphasizes healthy oils.
72
```
Nutrient density
A. Refers to high calorie foods.
B. Allows the nutritional qualities of foods to be easily evaluated.
C. Is a measure of the weight of a food.
D. Is an outdated term
```
B allows the nutritional qualities of foods to be easily evaluated.
73
```
RDA's, originally developed in 1941, were developed with _________ as their primary focus.
A. Optimal health.
B. Preventing overeating.
C. Preventing deficiency disease.
D. Preventing vitamin toxicity.
```
C preventing deficiency disease.
74
```
DRI's were developed to address
A. Chronic disease risk.
B. Management of diabetes.
C. Problems with food processing.
D. Pesticide use.
```
A chronic disease risk.
75
All of the following are major themes in the 2010 Dietary Guidelines for Americans EXCEPT
A. Balancing calories to manage weight.
B. Foods and nutrients to increase.
C. Supplements to take for optimal health.
D. Foods and food components to reduce.
C supplements to take for optimal health.
76
Many major organizations such as the USDA, the American Heart Association, and the American Diabetes Association recommend a daily cholesterol intake less than 300 mg.
A. True.
B. False.
T
77
The primary purpose of the food exchange system is
A. Assuring adequacy of vitamin and mineral intake.
B. Controlling energy consumption.
C. Preventing heart disease.
D. Decreasing protein consumption.
B
78
```
New American Plate was developed by the American Institute for Cancer Research and the World Cancer Research Fund to emphasize
A. Low fat dairy products.
B. High protein diet.
C. Plant foods.
D. Low carbohydrate diet.
```
C plant foods.
79
The UL for a particular nutrient describes
A. The intake to aim for
B. The level above which the nutrient has a risk of adverse effects.
C. The level below which the nutrient intake is inadequate.
D. An unknown intake.
the level above which the nutrient has a risk of adverse effects
80
```
Nutritional Assessment methods include all of the following except
A. Anthropometric.
B. Biochemical.
C. Clinical.
D. Estimation.
```
estimation.
81
```
Every lipoprotein contains all of the following except
A. Triglyceride.
B. Cholesterol.
C. Enzymes.
D. Protein.
```
enzymes.
82
As an individual's HDL increases, their risk of myocardial infarction remains
A. Constant.
B. Increases.
C. Decreases.
decreases.
83
According to the most recent report by the National Cholesterol Education Program (Adult Treatment Panel III or ATP III), presence of major CHD risk factors should
A. Lower the value for LDL cholesterol goals.
B. Raise the value for LDL cholesterol goals.
C. Lower the value for HDL cholesterol goals.
D. Raise the value for HDL cholesterol goals.
lower the value for LDL cholesterol goals.
84
According to "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", individuals with a systolic blood pressure of 120-139 mmHg or a diastolic blood pressure of 80-89 mmHg should be considered as prehypertensive and require health-promoting lifestyle modifications to prevent CVD.
A. True.
B. False.
True
85
```
A fasting specimen is most important for accurate measurement of
A. Cholesterol.
B. Triglyceride.
C. HDL.
D. C-reactive protein.
```
triglyceride.
86
The ATP III recommends a fasting lipoprotein profile be performed
A. On all adults ages 50 years or more at least once every 5 years.
B. On all adults ages 20 years or more at least once every 5 years.
C. On all adults ages 50 years or more at least once every year.
D. On all adults ages 20 years or more at least once every year.
on all adults ages 20 years or more at least once every 5 years.
87
The mechanism of entry of LDL into cells is through direct absorption through
A. The cell membrane.
B. Hormone-mediated reaction.
C. Endocytosis made possible by receptors that cluster in coated pits.
D. Active transport by an "LDL pump".
Endocytosis made possible by receptors that cluster in coated pits.
88
```
Initiation of the atherogenic process may begin in response to some form of endothelial injury. This injury could result from
A. Reduced LDL.
B. Oxidized LDL.
C. Reduced HDL
D. Any of the above.
```
oxidized LDL.
89
According to ATP III, major coronary heart disease risk factors include all of the following except
A. Hypertension.
B. Diabetes mellitus.
C. Current cigarette smoking.
D. High levels of chylomicrons in the blood.
high levels of chylomicrons in the blood.
90
```
A relationship has been demonstrated between large VLDL size, small LDL size, small HDL size and
A. Decreased caloric intake.
B. Decreased saturated fat intake.
C. Increased fiber intake.
D. Insulin resistance.
```
insulin resistance.
91
```
Which condition would be expected to cause the largest increase in alanine aminotransferase (ALT)?
A. Cirrhosis.
B. Hepatitis.
C. Pancreatitis.
D. Obstructive jaundice hepatitis.
```
hepatitis
92
An elevation of aspartate aminotransferase (AST) is specific for liver disease
A. True.
B. False.
false
93
```
In patients with jaundice, direct hyperbilirubinemia would most likely occur with
A. Gallstones.
B. Hepatitis.
C. Tylenol overdose.
D. Hemolysis
```
gallstones
94
Cirrhosis of the liver can cause an increased APTT because
A. Cirrhosis causes an increased production of heparin.
B. Cirrhosis causes decreased absorption of vitamin K.
C. Cirrhosis causes decreased platelet production.
D. Cirrhosis causes decreased production of coagulation factors.
cirrhosis causes decreased production of coagulation factors.
95
Increased blood ammonia levels correlate most closely with
A. Decreased alanine aminotransferase (ALT).
B. Increased alanine aminotranserase (ALT).
C. Decreased alkaline phosphatase (ALP).
D. Decreased gamma-glutamyl transpeptidase (GGT)
increased alanine aminotranserase (ALT).
96
```
The most sensitive indicator of chronic alcohol ingestion is
A. GGT.
B. AST.
C. ALT.
D. ALP.
```
GGT
97
```
Of the following choices, the serum elevation most specific for liver dysfunction is
A. AST.
B. ALT.
C. ALP.
D. Bilirubin.
```
ALT.
98
When jaundice is observed in an individual, it is important to differentiate whether the jaundice is primarily a result of direct (conjugated) or indirect (unconjugated) bilirubin. The best explanation for this
A. When liver cells are damaged, they lose the ability to conjugate.
B. When unconjugated bilirubin is increased, this rules out red blood cell damage.
C. When unconjugated bilirubin is increased, this confirms obstruction of the extrahepatic ducts.
D. Only cirrhosis causes an increase in unconjugated bilirubin.
When liver cells are damaged, they lose the ability to conjugate.
99
```
Elevated pyroglutamate in urine may indicate depletion of
A. Vitamin K.
B. Phase I activity.
C. Glutathione.
D. Glucaric acid.
```
glutathione.
100
```
When Phase I and Phase II liver detoxification pathways are actively working to rid the body of toxins, the most likely observation would be
A. High urinary orotate.
B. Low urinary orotate.
C. High urinary glucarate.
D. Low urinary glucarate.
```
high urinary glucarate
101
In a normally functioning hypothalamus-pituitary-adrenal (HPA) system, it is expected that increasing cortisol levels would result in ______________.
A. Negative feedback that increases ACTH.
B. Negative feedback that increases CRH.
C. Negative feedback that decreases ACTH.
D. Positive feedback that increases ACTH.
a negative feedback that decreases ACTH
102
```
An elevated TSH would most likely indicate
A. Hyperactive thyroid.
B. Hypoactive thyroid.
C. Hyperactive adrenals.
D. Hypoactive adrenals.
```
a hypoactive thyroid.
103
The most appropriate interpretation of a salivary cortisol is obtained___________.
A. From a specimen that has been collected in the early morning.
B. From a specimen that has been collected between 11:00PM and midnight.
C. From a specimen collected at noon.
D. From specimens collected throughout the day
from specimens collected throughout the day
104
```
Chronic stress can result in all of the following EXCEPT:
A. Increased salivary cortisol.
B. Insulin resistance.
C. Visceral obesity.
D. Increased TSH.
```
increased TSH.
105
What is the best explanation for measurement of free T4 to assess thyroid function?
A. Free T4 is the easiest assessment to perform.
b. Free T4 is the metabolically active thyroid hormone.
C. Free T4 is the most sensitive test to detect hypothyroidism.
D. Free T4 constitutes 99% of circulating thyroid hormone.
Free T4 is the metabolically active thyroid hormone.
106
```
The most biologically active thyroid hormone is
A. T3.
B. Free T3.
C. T4
D. T4.
```
free T3.
107
The MOST APPROPRIATE interpretation of a normal TSH, normal T4, decreased T3 is:
A. Hypothyroidism.
B. Decreased conversion of T4 to T3 due to extra-thyroidal factors.
C. Compensated hyperthyroidism.
D. Lab error
Decreased conversion of T4 to T3 due to extra-thyroidal factors
108
```
Thyroid peroxidase antibodies are closely linked with
A. Poor conversion of T4 to T3.
B. Decreased TSH.
C. Hypothyroidism.
D. Iodine deficiency.
```
hypothyroidism.
109
All of the following are appropriate strategies to suggest to someone with chronically high cortisol levels that appear to be the result of chronic stress EXCEPT
A. Maintain a healthy diet.
B. Engage in regular moderate activity.
C. Engage in strenuous activity.
D. Turn off electronic devices such as computers and TV at least one hour before bed to help improve sleep quantity and quality.
engage in strenuous activity.
110
```
The best measurement to assess cellular stores of vitamin C is
A. Plasma vitamin C level.
B. Leukocyte vitamin C level.
C. Urinary vitamin C level.
D. Erythrocyte vitamin C level.
```
leukocyte vitamin C level.
111
According to Cannell and Hollis, which statement is true regarding vitamin D status?
A. Vitamin D deficiency should only be suspected in those with symptoms of rickets.
B. Only children are at risk for vitamin D deficiency.
C. Virtually everyone has a chronic vitamin D deficiency.
D. Only the elderly are at risk for vitamin D deficiency.
Virtually everyone has a chronic vitamin D deficiency.
112
```
Which of the following nutrients would have the LEAST effect on a TBARS level?
A. Vitamin C.
B. Vitamin E.
C. Coenzyme Q.
D. Vitamin B6.
```
vitamin B6.
113
```
Which test result would you most expect in an individual that presents with bleeding gums and easy bruising?
A. Decreased plasma ascorbate.
B. Increased plasma ascorbate.
C. Decreased pyridoxal phosphate.
D. Increased pyridoxal phosphate.
```
decresased plasma ascorbate
114
```
Measurement of urinary xanthurenate would best assess _____.
A. Thiamin.
B. Niacin.
C. Riboflavin.
D. Vitamin B6
```
vitamin B6
115
The level of serum vitamin A
A. Is never measured.
B. Is never an accurate reflection of A status.
C. Is an accurate reflection of a toxic excess of vitamin A.
D. Is only accurate when performed on a fasting specimen.
is an accurate reflection of a toxic excess of vitamin A
116
```
Functional tests which assess oxidative changes in lipids may be used to assess vitamin ______ status
A. A
B. D
C. E
D. K
```
E
117
Which of the following conditions or diseases are known to be caused by a deficiency of the same nutrient?
A. Osteomalacia and rickets.
B. Xerophthalmia and breath pentane release.
C. Kwashiorkor and fibrocystic breast disease.
D. Hemolytic anemia and megaloblastic anemia.
osteomalacia and rickets
118
```
Plasma concentration of ________ seems to offer the best index of vitamin D status.
A. 1,24,25-(OH)3 D3
B. 1,25-(OH)2 D3
C. 25-OH D3
D. Cholecalciferol
```
25-OH D3
119
```
Morphological changes in epithelial cells would most likely indicate a deficiency of vitamin
A. A.
B. D.
C. E.
D. K.
```
A.
120
Which of the following activities is shared by vitamin B12 and folate?
A. Both are required for nucleic acid synthesis.
B. Both are considered problem nutrients for strict vegetarians.
C. Both are found in significant amounts in green leafy vegetables.
D. Both require intrinsic factor for their release from food proteins.
Both are required for nucleic acid synthesis.
121
It is especially important for women of child-bearing age to consume adequate folate because
A. They are a high risk group for developing anemia.
B. Can decrease the risk of hemolysis in a fetus.
C. Can decrease the risk of spina bifida in a fetus.
D. It can decrease the risk of pernicious anemia in a fetus.
it can decrease the risk of spina bifida in a fetus.
122
```
Which of the following is required for the absorption of dietary vitamin B12?
A. Bile
B. Lipase
C. Intrinsic factor
D. Folate
```
intrinsic factor
123
What is the most common treatment for pernicious anemia?
A. Injection of cobalamin.
B. Topical administration of liver extract.
C. Oral supplements of B-vitamin complex.
D. Diet high in liver and green leafy vegetables.
injection of cobalamin
124
It is important to detect pernicious anemia early because
A. It can lead to birth defects.
B. It can lead to irreversible neuropathy.
C. It can lead to blindness.
D. It can lead to a dangerous increase in xanthurenic acid.
it can lead to irreversible neuropathy.
125
An expected MCV for pernicious anemia would be
A. Below normal.
B. Normal.
C. Above normal.
above normal.
126
Folate supplements may mask the anemia due to a vitamin B12 deficiency
A. True.
B. False.
true
127
```
Serum folate levels reflect
A. Folate tissue status.
B. Liver folate stores.
C. Bone marrow folate levels.
D. Recent dietary intake.
```
recent dietary intake.
128
Which statement is the most accurate?
A. It is almost impossible to differentiate B12 and folate deficiency.
B. There is an inverse relationship between vitamin B12 and methylmalonic acid.
C. There is an inverse relationship between folate and methylmalonic acid.
There is an inverse relationship between vitamin B12 and methylmalonic acid.
129
```
The most common cause of B12 deficiency is
A. Inadequate intake.
B. Atrophic gastritis.
C. Multiple pregnancies.
D. Oral contraceptive use.
```
atrophic gastritis
130
```
Which of the following compounds provides a major storage reservoir for iron?
A. Ferritin.
B. Myoglobin.
C. Transferrin.
D. Hemoglobin.
```
ferritin
131
```
Which of the following symptoms would ordinarily not be found in individuals with iron-deficiency anemia.
A. Fatigue.
B. Headaches.
C. Concave nails.
D. Diminished sense of smell.
```
diminished sense of smell
132
```
Which of the following population groups is least susceptible to iron deficiency anemia?
A. Older infants.
B. Children, 2-10 years of age.
C. Women of childbearing age.
D. Men 20-45 years of age
```
men 20-45 years of age
133
Which of the following is found in the first stage of iron deficiency?
A. Iron stores decline as assessed by serum ferritin.
B. Hemoglobin levels fall, as assessed by complete blood count.
C. Red blood cell count falls, as assessed by hematocrit count.
D. Hemoglobin synthesis declines, as assessed by erythrocyte protoporphyrin.
Iron stores decline as assessed by serum ferritin.
134
```
Which of the following disorders is strongly correlated with the presence of high blood iron?
A. Dermatitis.
B. Heart disease.
C. Diverticulosis.
D. Neural tube defects.
```
heart disease
135
```
What is erythrocyte protoporphyrin?
A. An iron storage protein.
B. An immature red blood cell.
C. An iron binding protein.
D. Precursor for hemoglobin synthesis.
```
a precursor for hemoglobin synthesis
136
```
Symptoms of hemochromatosis most often become apparent in males
A. When they are toddlers.
B. Before the age of 18.
C. After age 40.
D. After age 60.
```
after age 40.
137
```
Which of the following would be an expected result in an individual with iron-deficiency anemia?
A. Decreased TIBC.
B. Increased MCV.
C. Decreased erythrocyte protoporphyrin.
D. Decreased transferrin saturation.
```
decreased transferrin saturation
138
A decreased hemoglobin would be expected
A. Before iron stores have been depleted.
B. Whenever ferritin values are low.
C. During late stages of iron deficiency.
D. Before erythrocyte protoporphyrin decreases.
during late stages of iron deficiency
139
The job of transferrin is to
A. Store iron excess to prevent toxic reactions.
B. Transport iron in its oxidized ferric state.
C. Act as a precursor to hemoglobin synthesis.
D. Enhance iron absorption by converting it to its ferrous state.
transport iron in its oxidized ferric state.
140
The association between serum calcium levels and dietary calcium intake can best be described as
A. Strong positive correlation
B. Strong negative correlation.
C. Virtually no correlation.
virtually no correlation.
141
A low serum calcium level can best be explained by
A. Hyperparathyroidism.
B. Hypoalbuminemia.
C. Failure to include dairy products in the diet.
D. Excessive intake of vitamin D.
hypoalbuminemia.
142
Phosphorus deficiency
A. Is a large concern in people over 50 years of age.
B. Is rare.
C. Is most common in adolescents.
D. Is associated with large soda consumption.
is rare.
143
When measuring serum magnesium
A. Lysis of red blood cells will cause a falsely low result.
B. Lysis of red blood cells will cause a falsely high result.
C. Lysis of red blood cells will have no effect on the result.
D. Lysis of red blood cells is desirable because magnesium is primarily an intracellular ion
lysis of red blood cells will cause a falsely high result.
144
```
The correct test to perform to determine physiologically active calcium is
A. Ionized calcium.
B. Fasting calcium.
C. Total calcium.
D. Protein-bound calcium.
```
ionized calcium.
145
Low magnesium levels may aggravate cardiac arrhythmias
A. True.
B. False.
true
146
The only way to diagnose osteoporosis and determine risk of future fractures is
A. 2-3 serum calcium measurements performed on different days.
B. Calcium level determined on a 24-hour urine specimen.
C. Measurement of serum PTH.
D. Bone mineral density test.
bone mineral density test.
147
When interpreting results from a bone mineral density test
A. The T-score is the most meaningful value.
B. The Z-score is the most meaningful value.
C. A negative score is desirable.
D. The T-score must be compared to serum calcium levels.
the T-score is the most meaningful value.
148
Zinc deficiency is most likely present if
A. Urinary zinc levels are lower than expected.
B. Serum zinc levels are lower than expected.
C. Serum zinc and metallothionen are both below expected levels.
D. Serum zinc is below expected levels, but metallothionen is above expected levels.
serum zinc and metallothionen are both below expected levels.
149
```
Evaluating taste acuity can help to assess _____ status.
A. Zinc.
B. Magnesium.
C. Calcium.
D. General mineral.
```
zinc
150
```
Long-term exposure to cadmium would be most likely to cause
A. Anemia.
B. Fragile bones.
C. Heart attack.
D. Dermatitis.
```
fragile bones.
151
```
The primary screening method for assessing lead levels
A. Is erythrocyte protoporphyrin.
B. Urinary lead.
C. Blood lead.
D. Bone x-ray.
```
blood lead.
152
```
One should be most concerned about mercury exposure from
A. Swordfish.
B. Flounder.
C. Salmon.
D. Shrimp.
```
swordfish.
153
Lead poisoning would be most likely observed in
A. A child living in the South.
B. A child living in a home built after 1978.
C. A child that drinks large quantities of milk.
D. A child living in a 75-year-old home.
a child living in a 75-year-old home.
154
```
Dental amalgams are a potential source of
A. Mercury.
B. Lead.
C. Cadmium.
D. All 3 of these heavy metals.
```
mercury.
155
Measuring cadmium in hair and nails
A. Provides useful information about recent exposure.
B. Provides useful information about past exposure.
C. Is not as useful as urinary cadmium levels.
D. Is more accurate than blood cadmium levels.
is not as useful as urinary cadmium levels.
156
Anemia is a symptom of ________ poisoning.
A. Mercury.
B. Lead.
C. Cadmium.
lead
157
```
Most lead that enters the body moves into the ________ within several weeks.
A. Liver.
B. Heart.
C. Bones and teeth.
D. Kidneys.
```
bones and teeth
158
```
Blood mercury levels provide the best information about
A. Recent mercury exposure.
B. Long-term mercury exposure.
C. Metallic mercury exposure.
D. Inorganic mercury exposure.
```
recent mercury exposure.
159
```
The biggest source(s) of cadmium exposure for people in the general population are
A. Paints.
B. Hair dyes.
C. Cigarette smoke and food.
D. Tap water.
```
cigarette smoke and food.
160
A sensitive assessment of folate status is:
A. Urinary formiminoglutamic acid (FIGLU).
B. Urinary methylmalonic acid (MMA).
C. Urinary beta-hydroxybutyric acid.
D. Urinary homovanillic acid.
Urinary formiminoglutamic acid (FIGLU).
161
```
Elevated fecal lactoferrin would most likely be observed in
A. Ulcerative colitis.
B. GERD.
C. Irritable bowel syndrome.
D. Lactose intolerance.
```
Ulcerative colitis.
162
What is the most accurate statement describing the impact of SNPs on phenotype?
A) identifying SNPs is the most accurate method to diagnose disease
B) Nutrients may alter the action of SNPs
C) SNPs have no effect on nutrient requirements
D) Every chronic disease has a single SNP associated with it
Nutrients may alter the action of SNPs
163
```
A food group that is missing from the MyPlate graphic is
A) fat
B) Meat
C) fruit
D) grains
```
fat
164
A computerized diet analysis indicates that your client is just meeting RDA for magnesium. What is the most appropriate conclusion based on this information?
A) Mg supplementation should definitely be avoided
B)Mg is an important mineral and every would benefit from supplementation
C) Clinical and biochemical information should be considered before making a decision on Mg supplementation
D) Data entry was probably inaccurate as most people have a Mg intake significantly over RDA
Clinical and biochemical information should be considered before making a decision on Mg supplementation
165
```
Which type of dietary assessment would be most appropriate for correlating food with mood?
A) computerized dietary analysis
B) 24-hour recall
C) food diary
D) food frequency questionnaire
```
food diary
166
In the article, Fat: an evolving issue, Speakman and O'Rahily, cite evidence that
A) interactions between genes and environment complicate the understanding of causes of obesity
B) genetics has no impact on obesity
C) obesity is primarily a result of decreased physical activity
D) positive energy balance is the only explanation required to explain the increase in obesity
interactions between genes and environment complicate the understanding of causes of obesity
167
```
Determination of body density by under-water weighing allows estimation of
A) body fat
B) BMR
C) bone mass
D) BMI
```
body fat
168
According to the article, Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes, which of the following is an accurate statement?
A) obesity induces inflammation
B) insulin resistance is unrelated to inflammation
C) obesity results in a marked decrease of tumor necrosis factor alpha (TNFalpha)
D) there is no relationship between obesity and inflammation
obesity induces inflammation
169
```
Sarcopenia refers to
A) a low BMI
B) a loss of muscle mass
C) a loss of appetite
D) a loss of body fat
```
a loss of muscle mass
170
Physical signs are important in nutritional assessment because, when present,
A) they are specific for a particular nutrient deficiency
B) they eliminate the need to do a dietary assessment
C) they rule out nutrient deficiency
D) they can offer clues into what nutrient insufficiencies may be present
they can offer clues into what nutrient insufficiencies may be present
171
```
What is the most likely explanation for a low level of all essential amino acids in a blood specimen?
A) steroid use
B) toxicity from chemicals
C) inadequate protein digestion
D) vitamin B6 deficiency
```
inadequate protein digestion
172
```
assessment of the aromatic amino acids phenylalanine, tyrosine, and tryptophan can provide information regarding ---- because they are converted to catecholamines and serotonin
A) glutathione synthesis
B) muscle catabolism
C) collagen synthesis
D) neurotransmitter metabolism
```
neurotransmitter metabolism
173
Biochemical assessment of protein typically includes assessment of
A) cartilage and tendon protein
B) somatic and visceral protein
C) skin and bone protein
somatic and visceral protein
174
```
The most sensitive indicator of glomerular damage in the kidney is
A) nitrates present in urine
B) protein present in urine
C) crystals present in urine
D) specific gravity of urine
```
protein present in urine
175
```
Which of the following is the most likely explanation for positive nitrites in a urine specimen and observation of white blood cells in urine sediment?
A) recent heart attack
B) urinary tract infection
C) diabetes
D) kidney stones
```
urinary tract infection
176
```
What is the most likely reason for a high urine specific gravity?
A) dehydration
B) urinary tract infection
C) compromised kidney function
D) overhydration
```
dehydration
177
Which of the following best describes an organic acid?
A) essential nutrient
B) compound synthesized in the GI tract that is necessary for digestion
C) product of metabolism that can be used to identify nutrient deficiencies
D) toxin that must be excreted
product of metabolism that can be used to identify nutrient deficiencies
178
```
The best assessment of glomerular filtration rate is
A) urine pH
B) examination of urinary sediment
C) serum creatinine
D) urine nitrites
```
serum creatinine
179
```
In which area is urinary organic acid assessment the most useful to nutritionists?
A) detecting a kidney infection
B) detecting dysbiosis
C) confirming a heart attack
D) diagnosing cance
```
detecting dysbiosis
180
According to recent research, intestinal hyperpermeability is associated with
A) rapid and efficient absorption of nutrients
B) negative hydrogen breath tests
C) an increased risk of developing autoimmune diseases
D) strong tight junctions between intestinal epithelial cells
an increased risk of developing autoimmune diseases
181
What best explains presence of glucose in urine?
A) it is expected to be present 1-2 hours after meals
B) it is a normal physiological response after drinking one can of soda
C) it occurs when blood glucose exceeds the renal threshold of 160-180 mg/dL
D) it indicates kidney disease
it occurs when blood glucose exceeds the renal threshold of 160-180 mg/dL
182
What is the best description of a lipoprotein?
A) blood proteins that indicate excessive inflammation in the body
B) blood proteins that are always associated with hypertension
C) blood proteins that should be kept as low as possible
D) blood proteins that carry lipids
blood proteins that carry lipids
183
According to the article, A New Perspective on Cardiovascular Disease
A) cardiovascular disease is a result of a normal protective response to chronic insults to endothelium
B) cardiovascular disease could be eradicated with appropriate antioxidant therapy
C) current guidelines from the AHA are the best strategy for identifying cardiovascular risk
D) the most effective strategy for decreasing risk of cardiovascular disease os to lower HDL to below 40 mg/dL
cardiovascular disease is a result of a normal protective response to chronic insults to endothelium
184
```
A relationship has been demonstrated between small LDL size and
A) decreased caloric intake
B) decreased saturated fat intake
C) increased cardiovascular risk
D) increased fiber intake
```
increased cardiovascular risk
185
```
Although alkaline phosphatase (ALP) is often used as a marker of liver disease, it is also frequently elevated in
A) kidney disease
B) stroke
C) bone disease
D) pernicous anemia
```
C
186
What is the most accurate description of glutathione's functions?
A) antioxidant and component of detoxification mechanism
B) blood coagulation and component of detoxification mechanism
C) blood coagulation and bilirubin conjugation
D) antioxidant and component of urea cycle
antioxidant and component of detoxification mechanism
187
```
Elevated blood ammonia is an indicator of
A) severe liver disease
B) kidney disease
C) hemolytic anemia
D) high level of detoxification
```
A
188
In a normally functioning HPA system, it is expected that increasing cortisol levels would result in
A) a negative feedback that increases CRH
B) a negative feedback that decreases ACTH
C) a positive feedback that increases ACTH
D) a negative feedback that increases ACTH
a negative feedback that decreases ACTH
189
```
Antithyroid peroxidase antibodies are closely linked with
A) poor conversion of T4 to T3
B) hypothyroidism
C) decreased TSH
D) iodine deficiency
```
hypothyroidism
190
What is the best interpretation of a high amount of urinary N-terminal telopeptides of type-1 collagen (NTx)
A) this is an indication of excessive calcium intake
B) this is an indication of excessive zinc intake
C) this is an indication of high amount of bone resorption
D) this is a definitive diagnosis of osteoporosis
this is an indication of a high amount of bone resorption
