NAME: ___________________________________
DATE: _____________ SECTION:___________
NUTRITION & DIET THERAPY- LECTURE
MIDTERMS EXAM- set B
EXAM RULES:
1. DO NOT cheat, copy, give anything to or take
anything from another student, otherwise you will
not be allowed to continue the exam.
2. DO NOT make any noise in the exam room
3. No erasures or revisions
4. DO LEAVE THE ROOM DURING THE EXAM
5. NO mobile phones/smart watches or any
electronic devices on your table
6. Use blue or black pen only on your final answers
MULTIPLE CHOICE: Select the correct answer/s
1. The amount of weight a woman gains during
pregnancy is an important indicator of fetal
growth. However, adequate weight gain during
pregnancy cannot by itself ensure the delivery of a
normal-birth-weight infant.
A. True
B. False
2. Obese women should gain 11 to 20 pounds
during pregnancy. It is not known how much
weight severely obese women should gain during
pregnancy.
A. True
B. False
3. Fortified cereals are significant source of folic
acid. In fact, the recommended amount of folic
acid could easily be exceeded with fortified cereal
A. True
B. False
4. Iron is the nutrient of most concern when solids
are introduced into the diet of infants.
A. True
B. False
5. An overweight child is more likely to develop
complications of adult overweight, such as
diabetes, hypertension, and metabolic syndrome.
A. True
B. False
6. In general, calorie needs in older adults
decrease due to a decrease in lean body mass and
physical activity while the need for other nutrients
stays the same or increases.
A. True
B. False
7. Most older adults consume adequate amounts
of iron. In fact, they cautioned against consuming
supplements to ensure adequacy.
A. True
B. False
8. When instituting nutrition therapy for a client
diagnosed with bulimia nervosa, the priority is to
A. Teach the client about nutrient and calorie
requirements
B. Halt weight loss
C. Normalize eating behaviors
D. Provide sufficient calories for weight gain
9. When instituting nutrition therapy for a client
diagnosed with anorexia nervosa, the priority is to
A. Teach the client about nutrient and calorie
requirements
B. Halt weight loss
C. Normalize eating behaviors
D. Provide sufficient calories for weight gain
10. Which of the following may help to promote
adherence to a hypocaloric diet?
A. a meal plan and recipes
B. A list of forbidden foods
C. A calorie counter
D. A fat gram counter
11. Which of the following calorie level ranges is
considered appropriate for weight loss diets for
most women?
A. 800-900 cal/day
B. 1000-1200 cal/day
C. 1400-1600 cal/day
D. 1800-2000 cal/day
12. Which of the following strategies promotes
adherence to exercise? Select all that apply.
A. Promote structure by encouraging the client to
exercise at on-site or supervised exercise sessions
B. Encourage the client to exercise in multiple
short bouts (10 minutes each), instead of on long
session
C. Encourage a more active lifestyle, such as
parking far away from the door when going to
the mall or work.
D. Encourage the client to exercise at home
13. The client asks if meal replacements, such a
Jenny Craig products, are a good idea to help with
weight loss. Which of the following would be the
nurse’s best response?
A. “They are a great way to control portions and
can help you adhere to your diet when used as
suggested.”
B. “ They are gimmicks that fail to teach you how
to control your own intake. They are not
recommended.”
C. “ Most people gain weight while using them.
You should stay away from them.”
D. “ They are not nutritionally balanced so you
actually have to overeat in order to meet your
nutritional requirements if you use them.”
14. A major reason why it becomes increasing
difficult to keep losing weight more quickly than
other weight loss diet is that
A. The loss of fat tissue lowers metabolic rate
B. A lighter body expands fewer calories than a
heavier body when doing activity
C. Fluid retention becomes an issue over time
D. A decrease in food intake means that fewer
calories are used to metabolize food
15. The client asks if it is okay for her to follow a
low carbohydrate (Atkins-type) in the short term
to get her started on her weight loss efforts.
Which of the following would be the nurse’s best
response?
A. “No, low-carbohydrate diets are not healthy
and would only sabotage your weight loss efforts.”
B. “Initially, a low-carbohydrate diet can help you
lose weight more quickly that other types of
diets, but over time, what is most important is
the amount of calories you eat, not the macro
nutrient distribution. You can try it, but
discontinue it if you experience any side effects.
C. “A low-carbohydrate diet is better than any
other type of diet and is a good choice for you to
use.”
D. “A low-fat diet is easier. Try that instead.
16. Breastmilk is recommended for the first 12
months of life because it offers complete nutrition
and _______ to the infant.
A. Fluoride
B. Fructose
C. Immunological protection
D. Pica
17. Which of the following is a characteristic of
iron deficiency in children?
A. It rarely develops in those with high intakes of
milk
B. It affects brain function before anemia sets in.
C. It is a primary factor in hyperactivity
D. Mild deficiency enhances mental performance
by lowering physical activity level, thereby leading
to increased attention span.
18. Three symptoms of lead toxicity are:
A. Diarrhea, irritability, and fatigue
B. Low blood sugar, hair loss, and skin rash
C. Increased HR, hyperactivity, and dry skin
D. Bleeding gums, brittle fingernails, and swollen
glands
19. Which of the following lifestyle habits can
enhance the length and quality of people’s lives?
A. Moderate smoking
B. Six hours of sleep daily
C. Regular physical activity
D. Skipping breakfast
20. Which of the following is among the better-
known relationships between nutrition and
disease prevention?
A. Appropriate fiber intake helps prevent goiter
B. Moderate sodium intake helps prevent obesity.
C. Moderate sugar intake helps prevent
hypertension.
D. Appropriate energy intake helps prevent
diabetes and CVD
21. A disease of the immune system that involves
painful inflammation of the joints is:
A. Sarcopenia
B. Osteoarthritis
C. Senile dementia
D. Rheumatoid arthritis
22. Examples of low-k calorie, high quality protein
foods include:
A. Cottage cheese, sour cream, and eggs diet. An appropriate action for the nurse to take
B. Green and yellow vegetables and citrus fruits would be to check the:
C. Potatoes, rice, pasta, and whole grain breads A. Diet manual
D. Lean meats, poultry, fish, legumes, fat-free B. Diet order
milk, and eggs C. Nutrition care plan
D. Medical record
23. For malnourished and underweight people,
protein- and energy- dense snacks include: 29. Fluid retention may cause all of the following
A. Fresh fruits and vegetables EXCEPT:
B. Yogurt and cottage cheese A. Swelling of limbs
C. Whole grains and high fiber legumes B. Facial puffiness
D. Scrambled eggs and peanut butter on wheat C. Weight loss
toast. D. Tight fitting shoes

24. Which of the following does NOT contribute to
dehydration risk in older adults?
A. They do not seem to feel thirsty
B. Total body water increases with age
C. They may find it difficult to get a drink
D. They may have difficulty swallowing liquids
25. Inadequate milk intake and limited exposure
to sunlight contribute to older adults risk of:
A. Vitamin A deficiency
B. Vitamin D deficiency
C. Riboflavin deficiency
D. Vitamin B12 deficiency
26. Two risk factors for malnutrition in older
adults are:
A. Loneliness and multiple medication use
B. Increased energy needs and lack of fiber
C. Decreased mineral absorption and antioxidant
intake
D. High carbohydrate intake and lack of physical
activity
27. Strategies to improve nutrition status when
growing old include:
A. Increasing vitamin A intake and exercising 30
minutes daily
B. Choosing nutrient dense foods and
maintaining appropriate weight.
C. Avoiding high fiber foods and taking a daily
vitamin-mineral supplement.
D. Eating at least one big meal per day and
drinking at least 10 glasses of water daily
28. A nurse notices a food on a patient’s tray and
is not sure if the food is allowed on the patient’s
30. A successful nutrition intervention would
include a long list of:
A. Dietary changes that the patient should
consider making
B. Food that the patient should avoid
C. Appetizing meals and foods that the patient
can include in the diet
D. Reasons why the patient should make dietary
changes
31. The most important factor(s) that affect(s)
how nutrition education is presented is (are):
A. The person’s nutrient needs and nutrition
status
B. The person’s abilities and motivation
C. The person’s medical history
D. The entries in the medical record.
32. A malnourished, acutely ill patient has just
begun to eat afterday s without significant
amounds of food. Which of the following blood
test results would change most quickly as the
patient’s nutrition and health status improves?
A. Albumin
B. Transferrin
C. Serum electrolytes
D. Retinol-binding protein
33. Which dietary assessment method does a
health practitioner use to conduct a kcalorie
count?
A. Direct observation
B. 24-hour recall interview
C. Food frequency questionnaire
D. Food record
34. Which statement indicates the mother
understands the nurse’s instructions about
breastfeeding?
A. “Breastfeeding should only last 5 minutes on
each breast.”
B. “Sometimes babies cry just because they are
thirsty, so a bottle of water should be offered
before breastfeeding begins to see if the infant is
just thirsty.”
C. “The longer the baby sucks, the less milk I will
have for the next feeding.”
D. “ The first breast offered should be alternate
with each feeding.”
35. A mother asks why toddlers shouldn’t drink all
the milk they want. Which of the following is the
nurse’s best response?
A. “Consuming more than the recommended
amount of milk can displace the intake of iron-
rich foods from the diet and increase the
toddler’s risk of iron deficiency anemia.”
B. “Consuming more than the recommended
amount of milk increases the risk of milk allergy,”
C. “Too much milk can lead to overhydration.”
D. “Consuming more than the recommneded
amount of milk will provide too much protein.”
36. The nurse knows her instructions about
introducing solids into the infant’s diet have been
effective when the mother states
A. “Babies should be introduced to solid foods at
1-3 months of age.”
B. “New foods should be given for 5-7 days so
that allergic responses can be easily identified.”
C. “Infants are more likely to accept infant cereal
for the first time if it is mixed with breast milk or
formula and given from a bottle.”
D. “The appropriate initial serving size for solids is
1 to 2 tbsp.”
37. Which of the following would be the best
snack for a 2-year-old?
A. Popcorn
B. Banana slices
C. Fresh cherries
D. Raw celery
38. A woman trying to become pregnant was told
by her physician to take a daily supplement
containing 400mcg of folic acid. She asks why a
supplement is better than eating folic acid through
food. Which statement is the nurses’ best
response?
A. “There are few natural sources of folate in
food.”
B. “Synthetic folic acid in supplements and
fortified foods is better absorbed, more available,
and a more reliable source than the folate found
naturally in food.”
C. “Folate in food is equally as good as folic acid in
supplements. It is just easier to take it in pill form
and then you don’t have to worry about how
much you’re getting in food.”
D. “If you are sure that you eat at least five
servings of fruits and vegetables every day, you
don’t really need to take a supplement of folic
acid.”
39. Which groups are adolescents most likely to
eat in inadequate amounts? Select all that apply.
A. Whole grains
B. Vegetables
C. Fruits
D. Meat
40. The client asks if her 10-year-old daughter
needs a weight loss diet. Which of the following
would be the nurse’s best response?
A. “Rather than a diet at this age, you should just
forbid her to eat sweets and empty calories.”
B. “Because prevention of overweight is more
effective than treatment, you should start to limit
her calorie intake by only serving low-fat and
artificially sweetened foods.”
C. “Ten-year-old girls are about to enter the
growth spurt of puberty, and it is natural for her
to gain weight before she grows taller. Diets are
not recommended for children, although healthy
eating and moderation are always appropriate.”
D. “ She needs extra calories for the upcoming
growth spurt, so you should be encouraging her to
eat more than she normally does.”
41. Calorie and nutrient requirements during
adolescence
A. Are higher than during adulthood because of
growth and development changes
B. Peak early and then fall until adulthood is
reached.
C. Are lower than during childhood.
D. Cannot be generalized because individual
variations exist.

42. Nutrients most likely to be deficient in an
adolescent’s diet are
A. Vitamin A and folate
B. Protein and vitamin C
C. Zinc and phosphorus
D. Iron and calcium
43. The amount of calories and protein needed
per unit of body weight is greater for infants than
for adults because of growth in the first year of life
is more rapid than at any other time in the life
cycle (excluding the fetal period)
A. True
B. False
44. A 68-year-old man who has steadily gained
excess weight over the years complains that it is
too late for him to make any changes in diet or
exercise that would effectively improve his health,
particularly the arthritis he has in his knees. Which
of the following would be the nurse
‘s best response?
A. “You’re right. You should have made changes
long ago. You cannot benefit from a change in diet
and exercise now.”
B. “It is too hard for older people to change their
habits. You should just continue what you’ve been
doing and know that it’s a quality of life issue to
enjoy your food.”
C. “It may not help to change your diet and
exercise, but it certainly wouldn’t hurt. Why don’t
you give it a try and see what happens?”
D. “It is not too late to make changes, and losing
weight through diet and exercising are more
effective at relieving arthritis pain than either
strategy is alone. And older people often are
better at making lifestyle changes than are
younger adults.”
45. The nurse knows her instructions about
vitamin B12 are effective when the client
verbalizes he will
A. Consume more meat
B. Consume more fruits and vegetables
C. Eat vitamin B12-fortified cereal
D. Drink more milk
46. A client complains that she is not eating any
more than she did when she was 30 years old and
yet she keeps gaining weight. Which of the
following would be the nurse’s best response?
A. “As people get older, they lose muscle mass,
which lowers their calorie requirements, and
physical activity.”
B. “You may not think you are eating more calories
but you probably are because the only way to gain
weight is to eat more calories that you burn.”
C. “Weight gain is an inevitable consequence of
getting older related to changes in your body
composition. Do not worry about it because older
people are healthier when they are heavier.”
D. “You need fewer calories now than when you
were 30. The only way to lose weight is to eat less
than you are currently eating.”
47. A mineral likely to be consumed in inadequate
amounts by older adults is
A. Iron
B. Potassium
C. Zinc
D. Sodium
48. The best dietary advice for the possible
prevention of Alzheimer disease is to
A. Consume a high fiber diet
B. Eat a heart healthy diet of fruits, vegetables,
whole grains, and seafood.
C. Take a multivitamin every day
D. Avoid foods with high glycemic index
49. Risk factors for malnutrition in older adults
include (select all that apply)
A. A decrease in food intake in the last 3 months
due to loss of appetite
B. Weight loss
C. Acute disease
D. Neuropsychological problems
50. Older adults doing resistance exercises to
rebuild lost muscle may also need to increase their
intake of what nutrient to achieve their objective?
A. Calories
B. Carbohydrate
C. Protein
D. Iron
51. Which of the following may help promote the
intake of a resident in long-term care? Select all
that apply.
A. Use simple verbal prompts to eat
B. Provide three meals a day; avoid snacks
C. Minimize noise and distractions in the dining
room
D. Offer finger foods
E. Honor individual preferences; solicit input
from resident and family
52. Which statement indicates the patient needs
further instruction about diet for nephrotic
syndrome>
A. “I know I need to eat a high-protein diet to
replace the protein lost in urine.”
B. “I need to limit my intake of saturated fat and
cholesterol.”
C. “I should not use salt in cooking or at the table
and avoid foods, condiments, and canned meat
and vegetables.”
D. “I am going to try substituting soy protein for
animal sources of protein because it may be better
for me.”
53. A client with predialysis CKD (Chronic Kidney
Dse) asks if it is okay that she saves all her meat
allowance for evening meal. Which of the
following would be the nurse’s best response?
A. ”You cannot have any meat on a predialysis
diet.”
B. “It doesn’t matter when you eat your meat
allowance, so if you prefer to save it all for dinner,
that is fine.”
C. “If you want ot eat your meat allowance all at
one time, it would be better to eat it for breakfast
so that your body has all day to metabolize it.”
D. “It is best if you spread your meat allowance
out over the whole day.”
54. When developing a teaching plan for a client
who is on dialysis, which of the following protein
sources would the nurse suggest for a client who
must also limit her intake of phosphorus?
A. Beef
B. Cheese
C. Tofu
D. Kidney beans
55. The nurse knows her instructions about
preventing future calcium oxalate stones have
been effective when the client verbalizes he
should
A. Avoid milk, cheese , and other sources of
calcium
B. Take megadoses of vitamin C
C. Consume a normal amount of dietary calcium
spread over the course of the day
D. Eat a high protein diet
56. How do the protein recommendations for
those with chronic kidney disease (CKD) without
diabetes differ from those who have diabetes?
A. Protein is more restricted for people who do
not have diabetes
B. Protein is more restricted for people who have
diabetes
C. The protein recommendations do not differ for
people with diabetes or without diabetes
D. There are no specific protein recommendations
for people with diabetes because carbohydrates
and fat are the priority concerns.
57. A client on hemodialysis ask if she can use
popsicles to help relieve her thirst. Which of the
following is the nurses’ best response?
A. “That’s a great idea as long as you deduct the
equivalent amount of fluid from your total daily
fluid allowance.”
B. “Popsicles are empty calories. You are better off
drinking just plain water.”
C. “Popsicles are great at relieving thirst, and
because they are solid, they do not count as fluid,
so you can eat them as desired.”
D. “Hot things are better at relieving thirst than
cold things. Try small amounts of hot tea or coffee
to relieve your thirst.”
58. One of the factors that influence protein
allowance during acute kidney injury is the
individual’s
A. Level of activity
B. Degree of catabolism
C. Blood pressure
D. Serum albumin concentration
59. The client asks if she will need to follow a diet
after she recovers from her kidney transplant.
Which of the following is the nurse’s best
response?
A. “You will always have to limit protein and
phosphorus intake to help preserve the health of
the new kidney.”
B. “After recovery, all restrictions are lifted and
you can eat anything you want.”
C. “You may need to modify some aspects of your
diet because of side effects from the medications
you will be taking, and you should continue to
eat a heart-healthy diet to decrease the risks of
diabetes, hypertension, and obesity.”
D. “All restrictions you followed before dialysis will
resume after you recover from the transplant.”
60. Which statement indicates the patient
understands the instruction about a DASH style
diet?
A. “The most important thing about a DASH diet is
to eat less cholesterol. No egg yolks for me.”
B. “I need to eat more fruits, vegetables, and
whole grains.”
C. “As long as I don’t add salt to my food while
cooking or at the table, I will be able to achieve a
low-sodium diet.”
D. “I had given up sugar-sweetened softdrinks but
now I am going to go back drinking them because
they are allowed in my diet.”
61. The client asks if he can continue using butter
on his DASH-style healthy diet. Which of the
following would be the nurse’s best response?
A. “No, butter does not fit into a hearty healthy
diet.”
B. “Butter is not limited in a heart healthy diet
because most people only use small amounts.”
C. “You can use small amounts of butter if you
are willing to compromise on other foods, such
as eating meatless meals occasionally.”
D. “You can use small amounts of butter if you
give up meat entirely.”
62. When developing a teaching plan for a client
on a low sodium diet, which of the following foods
would the nurse advise the client to limit?
A. Processed cheese
B. Canned fruit
C. Eggs
D. Milk
63. The nurse knows that instructions for a healthy
diet have been effective when the client expresses
a need to eat more
A. Oily fish and nuts
B. Lean red and deli meats
C. Diet soda and diet desserts
D. Italian bread and cornflakes
64. Which of the following recommendations
would be most appropriate to limit trans-fats?
A. Avoid red meats
B. Avoid egg yolks and shellfish
C. Avoid corn oil
D. Avoid commercially made baked goods and
stick margarine
65. A client asks how to alter a diet to lower high
triglyceride levels. Which of the following is the
nurse’s best response?
A. “Alcohol lowers triglycerides, but don’t drink
more than 2 drinks daily.”
B. “Lower your cholesterol intake by eliminating
egg yolks and butter.”
C. “Eat less sodium by avoiding processed foods
and don’t salt your food at the table.”
D. “Eat more fish and substitute whole grains for
refined grains.”
66. The client understands that losing weight will
help lower blood pressure. What does the client
need to know about weight loss diets?
A. For overall health and weight, it doesn’t matter
what kind of diet you choose.
B. A very low carbohydrate diet is best because it
promotes quick weight loss and is nutritionally
adequate in all food components known to
provide cardiometabolic benefits.
C. The appropriate calorie level DASH diet can
promote weight loss while providing adequate
amounts of food components that have cardio
metabolic benefits.
D. Low fat, low calorie diets are the best
overweight cardiac clients because benefits are
achieved from reducing all types of fat in the diet.
67. The number of 3 1/2 oz servings of oily fish
recommended is
A. 2/ month
B. 1/ week
C. 2/ week
D. 3-4/week
68. When developing a teaching plan for a patient
who has chronic diarrhea, which of the following
foods would the nurse suggest as an appropriate
source of potassium?
A. Tomato juice
B. Pinto beans
C. Milk
D. Broccoli
69. The nurse know his or her instructions have
been effective when the client with celiac disease
verbalizes that an appropriate breakfast is
A. Eggs
B. Grits with berries
C. Bran flakes cereal with milk
D. Buttermilk pancakes with syrup
70. Which of the following strategies would help a
client achieve a low-fat diet?
A. Substitute margarine for butter
B. Limit portion sizes of meat
C. Substitute whole wheat bread for white bread
D. Eat more fruit in place of vegetables
71. Which of the following may be an appropriate
source of calcium for a client who is lactose
intolerant?
A. Aged cheddar cheese
B. Pudding
C. Lean meat
D. Refined breads and cereals
72. Which for the following would be most
appropriate in modifying a regular diet to a high
fiber diet?
A. Ice cream in place of gelatin
B. Apple in place of apple juice
C. Rice in place of mashed potatoes
D. Cream of wheat in place of cream of ice.
73. Which of the following substitution results in a
healthier choice?
A. Beef loin instead of beef rib
B. Refried beans instead of cooked or canned
pinto beans
C. Natural cheese instead of low fat cheese
D. Baked potato with cheese sauce instead of
baked potato with salsa
74. A woman who has at her healthy weight when
she got pregnant is distraught by her 5-pound
weight gain between 20 and 24 weeks of
gestation. At this point in her pregnancy, her
weight gain is right on target. What is the nurse’s
best response?
A. “A 5-pound per month weight gain at this
point in your pregnancy is normal.”
B. “Although it is considerably less than the
recommended amount, it is not a cause for
concern. Just be sure to follow your meal plan
next month so you get enough calories and
nutrients.”
C. “ I recommend you write down everything you
eat for a few days so we can identify where the
problem lies.”
D. “A 5-pound weight gain in 1 month at this point
in your pregnancy may be a sign that you are at
risk of preeclampsia. You should cut back on the
‘extras’ in your diet to limit your weight gain for
next month.”
75. Which of the following conditions are
associated with a high-risk pregnancy? Select all
that apply.
A. Prepregnancy BMI of 20
B. Prepregnancy BMI of greater than 25
C. Maternal age of 30
D. Pregnancies spaced less than 18 months apart.
76. At her first prenatal visit, an overweight
woman asks how much weight she should gain
during the course of her pregnancy. What is the
nurse’s best response?
A. “You should not gain any weight during your
pregnancy. You have adequate calorie reserves to
meet all the energy demands of pregnancy
without gaining additional weight.”
B. “You should try to gain less than 15 pounds.”
C. “Aim for a 15-to 25- pound weight gain.”
D. “The recommended weight gain for your weight
is 25 to 35 pounds.”
77. Which of the following statements indicates
that the pregnant woman understands the
recommendations about caffeine intake during
pregnancy?
A. “I have to give up drinking coffee and cola.”
B. “I will limit my intake of coffee to about 2 cups
a day and avoid other sources of caffeine.”
C. “As long as I don’t drink coffee, I can eat other
sources of caffeine because they don’t contain
enough to cause any problems.”
D. “Caffeine is harmless during pregnancy, so I am
allowed to consume as much as I want.”
78. What nutrient is not likely to be consumed in
adequate amounts during pregnancy so a
supplement is recommended?
A. Iron
B. Calcium
C. Vitamin B12
D. Vitamin C

79. A woman at 5 weeks of gestation is

complaining of nausea throughout the day. What
should the nurse recommend?
A. Small, frequent meals of easily digested
carbohydrates
B. Small, frequent meals that are high in protein
C. A liquid diet until the nausea subsides
D. A low fiber intake

80. Which of the following statements is true?

A. Women who breastfeed almost always achieve
their prepregnancy weight at 6 weeks postpartum.
B. Weight loss during lactation is not
recommended because it lowers the quantity and
quality of breast milk produced.
C. Breastfeeding women do not have to increase
their intake by the full amount of calories it
‘costs’ to produce milk because they can mobilize
fat stored during pregnancy for some of the extra
energy required.
D. Women do not need to increase their calorie
intake at all for the first 6 months of breastfeeding
because they can use calories stored in fat to
produce milk.

END OF TEST
Honesty is the cornerstone of all success, without
which confidence and ability to perform shall
cease to exist- MKA