Download Nutrition, Obesity, and CVD Exam Q&A: Weight Management & Dietary Guidelines and more Exams Advanced Education in PDF only on Docsity!
MNT 2-3 Exam Questions And Correct
Answers
BMI Range Classifications - Answer -BMI < 18.5: Underweight
-BMI 18.5 to 24.9: Normal
-BMI 25.0 to 29.9: Overweight
-BMI 30.0 to 34.9: Obesity Class I
-BMI 35.0 to 39.9: Obesity Class II
-BMI 40 or higher: Obesity Class III
What are the key components of "Comprehensive Lifestyle Intervention" recommended for effective weight loss, as outlined by the 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults? Select all correct answers. - Answer
- Increased physical activity
- In-person, high intensity intervention with a trained interventionist
- Dietary pattern-based or macronutrient-based dietary changes to reduce energy intake Correct
- Self-monitoring of food intake, physical activity, and body weight Correct
Visceral or abdominal obesity (i.e. apple-shape) is associated with a higher CVD risk than gynoid (pear-shape) obesity. Match each of the following terms with the appropriate fruit-related term. - Answer - Android obesity (apple shaped)
-Gynoid obesity (pear shaped)
-Visceral or abdominal obesity (apple shaped)
Which of the following would be useful to include in an initial exploration with a new client, to better understand the client's priorities and level of interest and motivation to make lifestyle changes to achieve weight loss? - Answer 1. Support expected from family and friends
- Previous attempts at weight loss
- Potential barriers to change
- Time availability
- Reasons and motivation for weight loss
Which of the following statements are TRUE about low carbohydrate diets? - Answer
-They induce ketosis, particularly in the initial phase when carbohydrate intake is severely restricted; ketosis can cause reduced appetite and nausea which can help to decrease caloric intake and facilitate early weight loss.
-they may be effective for short term weight loss
True or False: The Paleo diet advocates increased intake of MUFA and PUFA (particularly omega-3 fatty acids), and reduced consumption of trans and some saturated fatty acids - although palm and coconut oil are recommended. - Answer True
Which of the following is the mechanism by which Orlistat works? - Answer Inhibits pancreatic lipase and decreases fat absorption
Roux-en-y gastric bypass - Answer Reduces the size of the stomach to approximately a 20 - 30 ml 'pouch', and brings part of the jejunum up to connect with the new gastric pouch, bypassing the duodenum. The proximal part of the jejunum is joined to the more distal jejunum further down, creating a 'Roux' limb or intestinal loop. This joining is called a jejunojejunostomy, and allows pancreatic, biliary, and gastric secretions and enzymes to mix with food.
sleeve gastrectomy - Answer 95% of the stomach is removed, leaving about 15% remaining capacity in a banana-shaped stomach 'sleeve'
biliopancreatic diversion - Answer The most malabsorptive of the bariatric procedures
adjustable gastric banding - Answer A band is applied near the stomach opening and can be tightened or loosened over time to change the size of the gastric outlet
True or False: The gastric pouch created in the Roux-en-Y gastric bypass procedure tends to be about the size of a medicine cup (i.e. 20 - 30 ml) - Answer True
Appropriate dietary recommendation for a person to follow after bariatric surgery? - Answer -Use small plates and utensils to control portions
-Avoid calorie containing beverages (except skim milk should be encouraged)
-Avoid fibrous fruits, vegetables, and meats
-Avoid alcohol and added sugar and rich/sweet foods
-Avoid gas forming foods and carbonated beverages
-Do NOT Minimize protein intake Correct
-Eat slowly, setting utensils down and waiting 1 minute between bites; chew slowly and thoroughly
-Consume liquids between, rather than with meals, in order to avoid dumping syndrome
-Consume 4 - 6 small meals/day, keeping the initial volume at 1 or 2 tablespoons of food
of a peripheral artery, that causes lameness and pain while walking
MI - Answer Death of cardiac tissue resulting from blockage that prevents flow of blood to or through the coronary arteries
Peripheral Vascular Center - Answer Occlusion of peripheral arteries, particularly those in the legs
coronary artery bypass graft (CABG) - Answer Surgical procedure involving the bypass of sections of occluded coronary arteries and the diversion of blood flow through grafted vessels in order to improve coronary artery blood flow by direct myocardial revascularization
angina pectoris - Answer Clinical syndrome due to myocardial ischemia characterized by episodic precordial discomfort or pressure; usually precipitated by exertion, and relieved by rest and nitroglycerin
Management strategies for coronary heart disease may include: - Answer 1. Cardiac rehabilitation to include supervised exercise, nutrition counseling and support for dietary modification to a heart-healthy diet, and other support 2. Medications for managing angina pectoris that may include beta blockers, calcium channel blockers, low-dose aspirin or other anticoagulants, and nitrates, e.g. nitroglycerin
- Dietary modification in accordance with the American College of Cardiology/American Heart Association's Guidelines on lifestyle management to reduce cardiovascular risk
- Aerobic exercise, in order to increase the work capacity of the heart
- PCI or CABG surgery, as needed
How does aspirin work as an anticoagulant? - Answer Blocks the synthesis of eicosanoids that promote blood clotting by inhibiting the enzyme cyclooxygenase
Tissue plasminogen activator (TPA) is used in the acute management of myocardial infarction because it: - Answer Is effective in dissolving intravascular clots when delivered directly to thrombosed area through a catheter
T/F: To reduce CVD risk in individuals with high blood pressure, the American Heart Association, American College of Cardiology, and the NHLBI/NIH recommends a diet
emphasizing vegetables, fruits and whole grains, lower fat sources of protein, and other general characteristics similar to the DASH diet (and other healthy eating patterns), along with a reduction of sodium intake of 2400 mg per day or less, and moderate to vigorous aerobic physical activity 3 to 4 sessions per week with an average of 40 minutes per session - Answer True
Component of the lifestyle management recommendations by the American Heart Association, American College of Cardiology, and the NHLBI/NIH, for adults who need LDL-C lowering? - Answer 1. Keep alcohol intake at a moderate level, e.g. no more than one drink per day for women and 2 drinks per day for men
- Consume a dietary pattern rich in fruits, vegetables and whole grains, with low-fat dairy, poultry, fish, legumes, nontropical vegetable oils and nuts, and limited intake of sweets, sugar-sweetened beverages and red meats
- Decrease saturated fat intake to no more than 5 - 6% of total kcals
- Aerobic physical activity 3 - 4X/week, average of 40 minutes/session
- NOT Reduce fat intake to 30% of total kcals
- Weight reduction (for those with overweight or obesity)
- Keep trans fatty acid intake to a minimum
T/F: Weight reduction by as little as 3 - 5% of body weight may be beneficial in reducing some CVD risk factors. - Answer True
Which of the following characterizes the adult weight management guidelines for overweight and obesity outlined by the AHA/ACC/TOS? - Answer 1. Behavior therapy that includes regular self-monitoring of food intake, physical activity, and weight, and that includes the support of a trained interventionist (e.g. RD or other provider) is recommended for effective weight loss.
- The initial weight loss goal is recommended to be 5 to 10% of baseline weight within 6 months..
- There is no one eating pattern recommended over any other to provide a reduced calorie diet; it should be individualized based on client goals, personal and cultural preferences, and other factors
- Moderately reduced calorie diet and a program of increased physical activity are cornerstones to the comprehensive lifestyle management recommended for effective weight loss
- Saturated fat and refined carbohydrates are eq - Answer 1. T
- T
- T
- T
- F
- T
- T
T/F: The link between saturated fat and heart disease has been questioned recently in the media. The meta-analysis conducted by Chowdbury et al published in the Annals of Internal Medicine in 2014 may be partly responsible for this; they reported no difference in heart disease risk with different levels of consumption of saturated fatty acid and monounsaturated fatty acid intake. However, their study has been heavily criticized for several important flaws that makes their findings somewhat questionable. - Answer T
Which of the following lifestyle factors may favor reduced CVD risk and/or reduced LDL-C levels?
- Consuming a Mediterranean-style diet
- Consuming PUFAs instead of saturated fatty acids
- Consuming trans fatty acids instead of saturated fatty acids
- Consuming substantial amounts of soy protein (25-40 g per day)
- Reducing total fat intake to 30% of total calories or less
- Consuming whole grains instead of refined starches and sugars
- Consuming the "Portfolio" diet
- Consuming 2-3 g plant stanols/sterols per day (isocaloric Lee substituting foods rich in sterols for other foods (e.g. sterol-enriched margarine in the place of butter or regular margarine)
- Decreasing intake of plant stanols/sterols to <1 g/day
- Increasing intake of soluble (i.e. viscous) fiber
- Reducing carbohydrate intake to 5% of total calories
l2. Increasing intake of saturated and trans fatty acids - Answer 1. T
- T
- F
- T
- F
- T
- F
- T
- F
- T
- F
- F
T/F: The original Portfolio combination diet consisting of 20 g/day viscous fiber, 2 g/day plant sterols/stanols, 50 g/day soy protein and 1 oz/day almonds in a vegetarian, low saturated fat dietary pattern reduced LDL-cholesterol by 75%, far greater than the effect of moderate-dose statin therapy. - Answer False
Which of the following are considered positive strategies to favor reduced serum triglycerides and increased HDL-C?
- Regular exercise
- Consumption of a low-fat, high refined carbohydrate diet
- Minimizing consumption of simple carbohydrate, particularly added sugars and fructose
- Substitution of MUFA and/or PUFA for carbohydrate calories (particularly those coming from added sugars and fructose)
- Consumption of omega-3 fatty acids, particularly those from wild, cold water marine fish, but also from plant foods including walnuts and flaxseed
- Consumption of more than moderate amounts of alcohol (e.g. more than 2 equivalents
5. F
T/F: There are a number of highly effective dietary approaches to reducing CVD risk factors. A combination of dietary components can achieve LDL-C lowering similar to pharmacologic approaches, and some dietary components (e.g. omega-3 fatty acids) may reduce CVD risk by mechanisms other than lowering LDL-C (e.g. lowering serum triglycerides, reducing inflammation). - Answer T
cerebral hemorrhage - Answer usually due to aneurysm
cerebral insufficiency - Answer due to transient disturbances of blood flow
cerebral infraction - Answer Due to embolism or thrombosis of intra- or extracranial arteries
People who have experienced a TIA or CVA are typically placed on anticoagulant therapy, e.g. with a medication like Coumadin. Which of the following statements is FALSE about this therapy:
- It acts by promoting the action of vitamin K in synthesizing clotting factors.
- It interferes with vitamin K's action to promote synthesis of clotting factors.
- It is important that individuals taking this medication maintain a consistent vitamin K intake in order to optimize the drug's effectiveness.
d. If a person consumes more vitamin K than he or she normally consumes, it will reduce the effectiveness of the medication. - Answer 1. F
- T
- T
- T
Aspirin works by blocking the synthesis of which class of signaling molecules? - Answer eiconsanoids
terms that mean cerebrovascular accident (CVA) - Answer cerebral infarction, complete stroke, apoplexy, ischemic stroke
Causes of dysphagia - Answer head injury, Parkinson's disease, MS, esophageal stricture, confused state due to metabolic imbalances or drug use
T/F: If a person has a "gurgly" or wet sounding voice after eating or drinking, you might consider the possibility that he or she might be experiencing dysphagia. - Answer T
Goals of the National Dysphagia Diet - Answer 1. Provide adequate hydration
- Provide foods that stimulate the swallowing reflex
- Maintain or improve nutritional status
NDD Levels - Answer 1: smooth, cohesive, no lumps
2: moist, soft textured foods with some cohesion
3: nearly regular diet without very hard, crunchy, or sticky foods
4: regular diet
T/F: Two helpful strategies to promote effective swallowing in a person with dysphagia are to discourage the patient from swallowing multiple times after each bolus, and to avoid coughing after they swallow. - Answer F
what is the most common type of genetic hyperlipidemia? - Answer Familial hypercholesterolemia (type IIa)
characterized by elevated LDL cholesterol levels >300 mg/dL at birth
How are individuals who are heterozygotes for familial hypercholesterolemia (Type IIa) managed clinically? - Answer 1. lifestyle management
- statin medications
pharmacologic intervention for hyperlipidemia - Answer -Treat elevated LDL-C with lifestyle management (including diet, exercise) and statins
-Both statin medications and nicotinic acid carry the risk for liver toxicity
How do HMG-CoA reductase inhibitors (statins) work tto reduce serum LDL-C? - Answer reduce hepatic cholesterol synthesis (by inhibiting HMG-CoA reductase enzyme) and upregulating LDL receptors in the liver
define heart failure - Answer -decreased CO as a result of impaired ventricle function OR
-clinical syndrome in which the heart fails to propel blood normally
Left ventricle failure symptoms - Answer -dyspnea on exertion
-pulmonary edema
-orthopnea
-tachypnea
-paroxysmal nocturnal dyspnea
-cheyne stokes respiration
-fatigue
Right ventricle failure symptoms - Answer -peripheral edema
-distended neck veins
-hepatic engorgement --> portal HTN & ascites
-inadequate circulation to GI system (anorexia, nausea, constipation, malabsorption, abdominal pain)
-low blood supply to the brain (mental confusion, memory loss, anxiety, insomnia, headache)
he adverse effects on the respiratory system associated with left ventricular failure results because: - Answer the heart is unable to adequately pump the blood returning
from the pulmonary circulation out of the heart, and the blood backs up into the pulmonary system causing pulmonary edema.
Why might a person with with right ventricular failure experience mental confusion and memory loss? - Answer They experience inadequate blood supply to the brain.
Cardiac cachexia - Answer severe malnutrition associated with long-term heart failure
According to the note set, which cytokines are contributing factors in the development of cardiac cachexia? - Answer TNF-α
IL-
why an individual with cardiac cachexia is potentially in danger as nutrition support is being initiated - Answer -Aggressive feeding can increase the workload of the heart and aggravate shortness of breath.
-Aggressive feeding can cause a rapid decrease in serum potassium, magnesium, and phosphorus.
- Hypophosphatemia can worsen respiratory distress because phosphorus has an important role in allowing red blood cells to offload their oxygen into the tissues.
Which of the following statements is TRUE regarding fluid accumulation and edema in individuals with heart failure?
- The drop in cardiac output decreases perfusion of the kidneys, leading to activation of the RAAS and increased reabsorption of sodium and fluid.
- The drop in cardiac output suppresses the renin-angiotensin-aldosterone system (RAAS), which causes increased venous pooling.
- The drop in cardiac output increases venous pressure, which increases renal blood flow and causes activation of the RAAS and increased reabsorption of sodium and fluid.
- The drop in cardiac output decreases venous pressure leading to increased reabsorption of sodium and fluid. - Answer 1
