Ch8 Nutritional Assessment in Disease Prevention Exam Prep

Chapter 08

Multiple Choice

1. Poor glycemic control in people with diabetes is associated with hemoglobin A1C levels that are ________.

A. essentially unchanged from what they are in people who do not have diabetes

B. greater than they are in people who do not have diabetes

C. less than they are in people who do not have diabetes

D. None of the choices are correct.

2. In persons with diabetes, the testing of urine is recommended for ________.

A. ketones only

B. glucose only

C. both glucose and ketones

3. In the primordial prevention of cardiovascular disease (CVD), risk factor intervention efforts are implemented ________.

A. before the risk factor even develops

B. once the risk factor has developed but before CVD is diagnosed

C. after CVD is diagnosed

D. at any time, regardless of when the risk factor develops or when CVD is diagnosed

4. According to the National Cholesterol Education Program, high HDL-C is considered a _______ risk factor because it _______ coronary heart disease risk.

A. positive; decreases

B. positive; increases

C. negative; decreases

D. negative; increases

5. The three major types of CVD are stroke, CHD, and ________.

A. CAD

B. PAD

C. HBP

D. TIA

6. The difference between the measured value as reported by a clinical laboratory and the "true" or "real" value is known as ________.

A. accuracy

B. coefficient of variation

C. precision

D. reproducibility

7. There are four goals of MNT for adults with diabetes. Which one of the following is NOT included in this list?

A. Promote a healthful eating pattern, with a variety of nutrient-dense foods

B. Focus on individual macronutrients, micronutrients, and single foods

C. Maintain the pleasure of eating by providing nonjudgmental messages about food choices

D. Address individual nutrition needs

8. Which one of the following values correctly represents pre-hypertension for an adult?

A. 120 over 80

B. 120-139 over 80-89

C. 140-159 over 90-99

D. 160 over 100

9. Which of the following cannot be accurately determined in the non-fasting state?

A. HDL-C

B. Non-HDL-C

C. Total cholesterol

D. Triglycerides

10. Lifestyle management is a fundamental aspect of diabetes care and includes six components. Which one of the following is NOT on this list?

A. Diabetes self-management education (DSME)

B. Nutrition therapy

C. Short-term fasting on a monthly schedule

D. Psychosocial care

11. Which of the following factors is not associated with increased prevalence of hypertension?

A. Increasing age

B. Being of African descent

C. Physical inactivity

D. A low waist circumference

12. In the primary prevention of cardiovascular disease (CVD), risk factor intervention efforts are implemented ________.

A. before the risk factor even develops

B. once the risk factor has developed but before CVD is diagnosed

C. after CVD is diagnosed

D. at any time, regardless of when the risk factor develops or when CVD is diagnosed

13. Which of the following is not a clinical determinant of the metabolic syndrome?

A. High-risk waist circumference

B. Elevated serum triglyceride level

C. Elevated serum HDL-C level

D. Elevated plasma glucose level

14. When a person lies down after standing for several minutes, serum cholesterol concentration ________.

A. increases

B. decreases

C. remains essentially unchanged

15. Given the conversion factor of 0.02586, which one of the following correctly represents a serum cholesterol level of 225 mg/dL?

A. 2.59 mmol/l

B. 5.82 mmol/l

C. 8.70 mmol/l

D. 87.01 mmol/l

16. Since the 1960s, the mean total serum cholesterol level of U.S. adults has ________.

A. increased

B. remained essentially unchanged

C. decreased

17. Since the 1950s, the age-adjusted death rate for diseases of the heart in the United States has ________.

A. increased

B. remained essentially unchanged

C. decreased

18. Which one of the following combinations cannot occur?

A. High precision, low bias

B. High precision, high bias

C. Low precision, low bias

D. Low precision, high bias

19. The primary purpose of the Friedewald equation is to calculate ________.

A. LDL-C

B. abdominal adiposity

C. percent lean body mass

D. triglycerides

20. The American Heart Association’s (AHA) 2020 goal is to reduce deaths from CVD and stroke by 20%. As a part of this initiative, the AHA tracks seven key health factors and behaviors called “Life’s Simple 7.” Which one of the following is NOT included in this list?

A. Not smoking

B. Control of cholesterol

C. Control of systemic inflammation

D. Healthy diet

21. The top risk factor related to overall disease burden, according to data reviewed by the AHA, was ________.

A. physical inactivity

B. suboptimal diet

C. tobacco smoking

D. high BMI

22. According to the AHA, the definition for ideal cardiovascular health includes a fasting plasma glucose of less than ________ mg/dl.

A. 100

B. 126

C. 140

D. 150

23. According to the AHA, the definition for ideal cardiovascular health in children and adolescents includes a serum total cholesterol of less than ________ mg/dl.

A. 180

B. 200

C. 125

D. 170

24. According to the AHA, a healthy diet score must meet four to five goals (based on a 2000-calorie/day diet). Which one of the following is NOT included?

A. Sodium of less than 1500 mg per day

B. Sugar-sweetened beverages of less than 750 calories per week

C. Two 3.5-ounce servings per week of fish

D. 4.5 cups per day or more of fruits and vegetables

25. Of the 7 AHA health metrics, ________ has the lowest prevalence for ideal behavior.

A. not-current smoker

B. total cholesterol less than 200 mg/dl

C. healthy dietary pattern

D. BMI < 25 kg/m²

26. The leading risk factor for stroke is ________.

A. high blood pressure

B. high blood glucose

C. cigarette smoking

D. diabetes mellitus

27. The metabolic syndrome is diagnosed when an individual has three or more of five risk factors. Which risk factor listed below is NOT on this list?

A. Plasma HDL cholesterol <40 mg/dL in men

B. Plasma triglycerides greater than 225 mg/dL

C. Waist circumference of more than 35 inches in women

D. Fasting plasma glucose of 100 mg/dL and higher

28. Despite an impressive drop from the 1960s, about _________ of Americans still have high-risk blood cholesterol levels (240 mg/dL and higher), with this proportion increasing to 28% when considering all individuals either with high blood cholesterol or on cholesterol-lowering medications.

A. 8%

B. 12%

C. 18%

D. 22%

29. Most clinical laboratories estimate the LDL-C using the Friedewald equation from individuals who are overnight fasted. What parameter is used to complete this equation (fill in the blank)?

LDL-C=TC−[HDL-C+(0.20×______)]

A. glucose

B. triglycerides

C. free fatty acids

D. dietary cholesterol

30. A fasting serum triglyceride level of 250 mg/dL would be classified as ________.

A. very high

B. normal

C. borderline high

D. high

31. The 2013 ACC/AHA guidelines identified four statin benefit groups. Which one of the following is NOT included in this list?

A. Those with arteriosclerotic cardiovascular disease (ASCVD)

B. Those with LDL-cholesterol values of 130 mg/dL and higher

C. People with type 1 or 2 diabetes who are 40–75 years of age with LDL-C of 70–189 mg/dL

D. People without diabetes who are 40–75 years of age with LDL-C of 70–189 mg/dL and have an estimated ASCVD 10-year risk of 7.5% and higher

32. In response to mounting evidence, an expert panel convened by the NHBLI in 2011 recommended universal dyslipidemia screening for all children starting between ________ of age.

A. 5 and 6 years

B. 9 and 11 years

C. 11 and 12 years

D. 7 and 8 years

33. A non-HDL cholesterol level of 130 mg/dl would be classified as ________

for a child or adolescent.

A. acceptable

B. high

C. very high

D. borderline high

34. About 3 in 10 adults have high blood pressure, with proportions highest among the elderly and ________.

A. Asians

B. Hispanic/Latino

C. African-Americans

D. White/not Hispanic

35. According to JNC8, in the general population aged ≥60 years, pharmacologic treatment to lower blood pressure (BP) should be initiated at a systolic blood pressure (SBP) ≥ ________ or diastolic blood pressure (DBP) ≥90mmHg and treat to a goal SBP <150 mm Hg and goal DBP <90 mm Hg.

A. 150 mmHg

B. 160 mm Hg

C. 170 mm Hg

D. 180 mm Hg

36. What lifestyle modification has the greatest influence in preventing and managing hypertension?

A. Adopt DASH diet

B. Dietary sodium reduction

C. Physical activity

D. Weight reduction

37. Which subgroup listed below has the highest prevalence of diabetes?

A. Age 65 years and older

B. African-Americans

C. Females

D. Hispanics

38. ________ diabetes is due to a progressive loss of β-cell insulin secretion frequently on the background of insulin resistance.

A. GDM

B. MODY

C. Type 1

D. Type 2

39. Which one of the following is NOT regarded as a typical symptom of diabetes?

A. Extreme fatigue

B. Blurry vision

C. Infrequent urination

D. Polyphagia

40. Which one of the following is NOT a risk factor for diabetes?

A. Older age

B. HDL-C >35 mg/dL and/or a triglyceride level >275 mg/dL

C. First-degree relative with diabetes

D. Body mass index (BMI) of 25 kg/m² and higher

41. An A1C level of _______% and higher is a risk factor for diabetes.

A. 5.7

B. 6.3

C. 7.5

D. 8.3

42. Asymptomatic adults should be screened for prediabetes or diabetes mellitus starting at age ________ years.

A. 30

B. 35

C. 40

D. 45

43. Children who are overweight and have two or more risk factors should be screened for diabetes mellitus starting at age ________ years.

A. 8

B. 10

C. 12

D. 5

44. The American Diabetes Association has several medical nutrition therapy recommendations for adults with diabetes. Which one of the following is NOT on this list?

A. Aim for at least 5% to 7% weight loss with an intensive lifestyle intervention program

B. Emphasize healthy eating patterns such as the Mediterranean, DASH, and plant-food based diets

C. Avoid all alcoholic beverages, and beverage with nonnutritive sweeteners

D. Don’t use carbohydrate sources high in protein to treat or prevent hypoglycemia

True/False

45. Type 2 diabetes is rarely diagnosed in individuals younger than 30 years of age.

46. Glycosylated hemoglobin is considered a good indicator of average blood glucose levels during the previous 8 to 12 weeks.

47. When classifying blood pressure in the pediatric population, the same cut-points are used as when classifying the blood pressure of adults.

48. Current clinical practice guidelines developed by the U.S. National Heart, Lung, and Blood Institute for preventing cardiovascular disease in children and adolescents do not recommend universal screening of lipid levels in children and adolescents.

49. One of the advantages of using non-HDL-cholesterol as an indicator of CHD risk is that it can be accurately determined in the non-fasting state.

50. Diastole refers to the phase of cardiac relaxation.

51. The majority of within-individual variability in cholesterol analyses is due to preanalytical factors.

52. Although precision is necessary in order for accuracy to exist, accuracy is not necessary in order for precision to exist.

Fill-in-the-Blank

53. Because cholesterol and triglycerides are fat soluble, they must be transported in the blood by spherical macromolecular complexes known as __________.

54. Risk factor intervention efforts that are implemented before a certain risk factor even develops are known as ________ prevention.

55. Individuals at increased risk of developing diabetes in the future because they have either impaired fasting glucose or impaired glucose tolerance are said to have ________.

56. Diabetes that develops during pregnancy is known as ________.