RD FINAL EXAM ALL CHAPTERS QUESTIONS WITH
ANSWERS LATEST UPDATE ALREADY GRADED A+
NCP - ANS-Nutrition Care Process. A standardized, consistent structure and framework used to provide
nutrition care. This is different from standardized care, which infers that all patients receive the same
care.
NCP Steps - ANS-ADIME
1. Assess, 2. Diagnose, 3. Intervention, 4. Monitor & Evaluate
Critical thinking - ANS-integrates facts, informed opinions, active listening, and observations. It is a
reasoning process where ideas are produced and evaluated. It includes the ability to conceptualize,
think rationally, think creatively, be inquiring, and think autonomously.
Nutrition screening - ANS-use of preliminary nutrition assessment techniques to identify people who are
malnourished or who are at risk for malnutrition.
All health care team members can participate.
Brief 5-10 minutes.
Nutrition screening review - ANS-client's history, lab results, weight, physical signs
For nutrition screening to be effective - ANS-the mechanism must be accurate based on: specificity (can
it ID patients without a condition), sensitivity (can it ID those who have the condition.
Mechanism must be effective as related to the chances that positive health outcomes will be achieved
with the intervention.
If no emerging nutrition problem exists - ANS-document that discharge from nutrition care is
appropriate
The Joint Commission and nutrition screening - ANS-nutrition risk identified in hospitalized patient
within 24 hours of admission, but does not mandate a method of screening
Nutrition screening includes - ANS-1. Subjective Goal Assessment
2. Mini Nutritional Assessment
3. Nutrition Screening Initiative
,Subjective Goal Assessment - ANS-History, intake, GI symptoms, functional capacity, physical
appearance, edema, weight change
NO lab values, just talking
Mini Nutritional Assessment - ANS-Evaluates independence, medication therapy, number of full meals
consumed each day, protein intake, fruits and vegetables, fluid, mode of feeding.
Often done in older population.
Nutrition Screening Initiative - ANS-Elderly
Nutrition assessment of individuals - ANS-Initiated by referral/screening of individuals or groups for
nutritional risk factors.
Assessment makes comparisons between data collected and reliable standards.
Assessment is an on-going, dynamic process that involves continual reassessment and analysis of
patient/client/group needs.
Assessment provides the basis for nutrition diagnosis.
Critical thinking skills needed in nutrition assessment include - ANS-1. Observe verbal/nonverbal cues
that can guide effective interviewing methods
2. Determine appropriate data to collect
3. Select tools and procedures and apply in valid, reliable ways
4. Distinguish relevant from irrelevant, and important from unimportant data
5. Validate, organize and categorize the data
Nutrition assessment component - ANS-1. Review: review data for factors that affect nutritional and
health status
2. Cluster: assessment data clustered for comparison with characteristics of a suspected diagnosis; food
and nutrition related history, anthropometrics, lab/medical tests (biochemical), nutrition-focused
physical findings, client history
3. These indicators are compared to identified standards and criteria for interpretation and decision-
making
Indicators in nutrition assessment - ANS-are clearly defined markers that can be observed and
measured.
Also used to monitor and evaluate the progress towards nutrition outcomes
What indicators are compared against - ANS-nutrition care criteria
Documentation in nutrition assessment - ANS-date and time, pertinent data and comparison with
standards, patient's perceptions, values and motivation related to problem; changes in patient's level of
understanding, behaviors, outcomes; reason for discharge
,Dietary intake assessment - ANS-1. Diet history
2. Food recall
3. 24 hour recall
4. Food frequency lists
Diet history - ANS-present patterns of eating. Do not ask leading questions.
Food record - ANS-exact record of everything eaten in a specific period of time
24 hour recall - ANS-mental recall of everything eaten in previous 24 hours.
Quick tool to estimate a sample daily intake.
Clinical setting.
Food frequency lists - ANS-how often an item is consumed. Community setting. QUICK way to determine
intakes of LARGE NUMBERS of people.
People do this by themselves.
Pertinent medical and family history - ANS-provides insight into nutrition-related problems
Physical findings - ANS-anthropometrics (body structure)
desireable body weight
Medium frame women - ANS-100 lbs for first 5 feet, add 5 lbs for each additional inch, subtract 5 lbs for
each inch below
Small frame women - ANS-subtract 10% from Hamwi method
Large frame women - ANS-add 10% to Hawmi method
Medium frame men - ANS-106 lbs for first 5 feet, add 6 lbs for each additional inch, subtract 6 lbs for
each inch below 5 feet
Small frame men - ANS-subtract 10% from Hamwi method
Large frame men - ANS-add 10% to Hamwi method
Amputations - ANS-entire leg: 16% of body weight
lower leg: with foot 6% of body weight
entire arm: 5% of body weight
forearm with hand: 2.3% of body weight
Amputation Estimated IBW - ANS-Estimated IBW = (100-%amputation)/100 x IBW for original body
weight
, Amputation % weight change - ANS-% weight change stresses significance of weight change
Used to assess potential nutrition risk**
[(usual weight - actual weight)/usual weight] x 100
Triceps skinfold thickness (TSF) - ANS-1. measures body fat reserves; measures calorie reserves
2. standard, male: 12.5 mm, female: 16.5 mm
Arm muscle area (AMA) - ANS-1. measure SKELETAL muscle mass (SOMATIC protein)
2. to determine: use triceps skinfold thickness and arm circumference
3. standard: male 25.3 cm; female 23.2 cm
4. important to measure GROWING CHILDREN
BMI body mass index, Quetelet Index - ANS-compares weight to height
1. weight in kg divided by height squared in meters; or weight in pounds divided by height in inches
squared x 703
2. healthy adult 18.5 - 24.9; healthy for most elderly 24-29
3. BMI for age charts starting at age 2 when accurate stature can be obtained
Waist circumference - ANS->40 males, >35 females is independent risk factor for disease when out of
proportion to total body fat (with BMI of 25-34.9)
Measured in inches
Waist/hip ratio (WHR) - ANS-1. differentiates between android (apple) and gynoid (pear) obesity
2. WHR of 1.0 or greater in men, 0.8 or greater in women is indicative of android obesity and an
increased risk for obesity-related diseases (diabetes, hypertension)
Nutrition focused physical exam - ANS-Hair
Skin
Eyes
Lips
Tongue
Gums
Teeth
Skin
Nails
Hair - ANS-Assessment: thin, sparse, dull, dry, brittle, easily pluckable
Considerations: vitamin C, protein deficiency
Eyes - ANS-Assessment: pale, dry, poor vision
Considerations: vitamin A, zinc or riboflavin deficiencies
ANSWERS LATEST UPDATE ALREADY GRADED A+
NCP - ANS-Nutrition Care Process. A standardized, consistent structure and framework used to provide
nutrition care. This is different from standardized care, which infers that all patients receive the same
care.
NCP Steps - ANS-ADIME
1. Assess, 2. Diagnose, 3. Intervention, 4. Monitor & Evaluate
Critical thinking - ANS-integrates facts, informed opinions, active listening, and observations. It is a
reasoning process where ideas are produced and evaluated. It includes the ability to conceptualize,
think rationally, think creatively, be inquiring, and think autonomously.
Nutrition screening - ANS-use of preliminary nutrition assessment techniques to identify people who are
malnourished or who are at risk for malnutrition.
All health care team members can participate.
Brief 5-10 minutes.
Nutrition screening review - ANS-client's history, lab results, weight, physical signs
For nutrition screening to be effective - ANS-the mechanism must be accurate based on: specificity (can
it ID patients without a condition), sensitivity (can it ID those who have the condition.
Mechanism must be effective as related to the chances that positive health outcomes will be achieved
with the intervention.
If no emerging nutrition problem exists - ANS-document that discharge from nutrition care is
appropriate
The Joint Commission and nutrition screening - ANS-nutrition risk identified in hospitalized patient
within 24 hours of admission, but does not mandate a method of screening
Nutrition screening includes - ANS-1. Subjective Goal Assessment
2. Mini Nutritional Assessment
3. Nutrition Screening Initiative
,Subjective Goal Assessment - ANS-History, intake, GI symptoms, functional capacity, physical
appearance, edema, weight change
NO lab values, just talking
Mini Nutritional Assessment - ANS-Evaluates independence, medication therapy, number of full meals
consumed each day, protein intake, fruits and vegetables, fluid, mode of feeding.
Often done in older population.
Nutrition Screening Initiative - ANS-Elderly
Nutrition assessment of individuals - ANS-Initiated by referral/screening of individuals or groups for
nutritional risk factors.
Assessment makes comparisons between data collected and reliable standards.
Assessment is an on-going, dynamic process that involves continual reassessment and analysis of
patient/client/group needs.
Assessment provides the basis for nutrition diagnosis.
Critical thinking skills needed in nutrition assessment include - ANS-1. Observe verbal/nonverbal cues
that can guide effective interviewing methods
2. Determine appropriate data to collect
3. Select tools and procedures and apply in valid, reliable ways
4. Distinguish relevant from irrelevant, and important from unimportant data
5. Validate, organize and categorize the data
Nutrition assessment component - ANS-1. Review: review data for factors that affect nutritional and
health status
2. Cluster: assessment data clustered for comparison with characteristics of a suspected diagnosis; food
and nutrition related history, anthropometrics, lab/medical tests (biochemical), nutrition-focused
physical findings, client history
3. These indicators are compared to identified standards and criteria for interpretation and decision-
making
Indicators in nutrition assessment - ANS-are clearly defined markers that can be observed and
measured.
Also used to monitor and evaluate the progress towards nutrition outcomes
What indicators are compared against - ANS-nutrition care criteria
Documentation in nutrition assessment - ANS-date and time, pertinent data and comparison with
standards, patient's perceptions, values and motivation related to problem; changes in patient's level of
understanding, behaviors, outcomes; reason for discharge
,Dietary intake assessment - ANS-1. Diet history
2. Food recall
3. 24 hour recall
4. Food frequency lists
Diet history - ANS-present patterns of eating. Do not ask leading questions.
Food record - ANS-exact record of everything eaten in a specific period of time
24 hour recall - ANS-mental recall of everything eaten in previous 24 hours.
Quick tool to estimate a sample daily intake.
Clinical setting.
Food frequency lists - ANS-how often an item is consumed. Community setting. QUICK way to determine
intakes of LARGE NUMBERS of people.
People do this by themselves.
Pertinent medical and family history - ANS-provides insight into nutrition-related problems
Physical findings - ANS-anthropometrics (body structure)
desireable body weight
Medium frame women - ANS-100 lbs for first 5 feet, add 5 lbs for each additional inch, subtract 5 lbs for
each inch below
Small frame women - ANS-subtract 10% from Hamwi method
Large frame women - ANS-add 10% to Hawmi method
Medium frame men - ANS-106 lbs for first 5 feet, add 6 lbs for each additional inch, subtract 6 lbs for
each inch below 5 feet
Small frame men - ANS-subtract 10% from Hamwi method
Large frame men - ANS-add 10% to Hamwi method
Amputations - ANS-entire leg: 16% of body weight
lower leg: with foot 6% of body weight
entire arm: 5% of body weight
forearm with hand: 2.3% of body weight
Amputation Estimated IBW - ANS-Estimated IBW = (100-%amputation)/100 x IBW for original body
weight
, Amputation % weight change - ANS-% weight change stresses significance of weight change
Used to assess potential nutrition risk**
[(usual weight - actual weight)/usual weight] x 100
Triceps skinfold thickness (TSF) - ANS-1. measures body fat reserves; measures calorie reserves
2. standard, male: 12.5 mm, female: 16.5 mm
Arm muscle area (AMA) - ANS-1. measure SKELETAL muscle mass (SOMATIC protein)
2. to determine: use triceps skinfold thickness and arm circumference
3. standard: male 25.3 cm; female 23.2 cm
4. important to measure GROWING CHILDREN
BMI body mass index, Quetelet Index - ANS-compares weight to height
1. weight in kg divided by height squared in meters; or weight in pounds divided by height in inches
squared x 703
2. healthy adult 18.5 - 24.9; healthy for most elderly 24-29
3. BMI for age charts starting at age 2 when accurate stature can be obtained
Waist circumference - ANS->40 males, >35 females is independent risk factor for disease when out of
proportion to total body fat (with BMI of 25-34.9)
Measured in inches
Waist/hip ratio (WHR) - ANS-1. differentiates between android (apple) and gynoid (pear) obesity
2. WHR of 1.0 or greater in men, 0.8 or greater in women is indicative of android obesity and an
increased risk for obesity-related diseases (diabetes, hypertension)
Nutrition focused physical exam - ANS-Hair
Skin
Eyes
Lips
Tongue
Gums
Teeth
Skin
Nails
Hair - ANS-Assessment: thin, sparse, dull, dry, brittle, easily pluckable
Considerations: vitamin C, protein deficiency
Eyes - ANS-Assessment: pale, dry, poor vision
Considerations: vitamin A, zinc or riboflavin deficiencies
