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Cursuscode VD-GLB-HLTHS5(gel2)/S6(gel1)-19 TOETS01
Gelegenheid 1e gelegenheid
Versie A
Toetsdatum 26-6-2020
Tijdstip toets 11.00-13.40u
Tijdsduur in minuten 160 min
Type vragen meerkeuze + open vragen
Aantal bladzijden Klik hier als u tekst wilt invoeren.
Aantal opgaven 55 meerkeuzevragen en 3 open vragen
Printinstructies zwart-wit dubbelzijdig
Docent A. Rotteveel, C Choi
Toegestane
woordenboek Engels-Nederlands/ Nederlands-Engels
hulpmiddelen

Bijlagen tentamen

☒ Tentamenpapier
☒ Vijfkeuze antwoordformulier
☐ Ja/nee antwoordformulier
☐ Ruitjespapier
☒ Kladpapier
☐ Bijlage(n) → Aantal: Klik hier als u tekst wilt invoeren.

Beoordeling tentamen
Cesuur open vragen 100% goed=10, 55% goed=5,5 10% goed =1,0
Cesuur Absoluut; 100% goed=10, 70% goed=5,5 33% goed
meerkeuzevragen =1,0
Cesuur verslag Klik hier als u tekst wilt invoeren.
Behaald resultaat Klik hier als u tekst wilt invoeren.
Inleveren bij surveillant:

☒Kladpapier ☒Opgaven ☐Bijlage(n)

Opmerkingen: Student mag UITSLUITEND kladblaadje mee met zijn eigen
antwoorden op de MC vragen, dus 1a, 2b, 3c, enz. Verder mag er niets op
staan.
LET OP: Student mag een eigen woordenboek gebruiken tijdens de toets.
Woordenboeken worden door surveillanten gecontroleerd.
Veel succes!!!

VERSIE A
Voorblad
VD-GLOB HLTH S5 (HERKANSING) S6 (1e kans)-19 55 MC en 35 pnt Open vrgn
1 Who of the following is most vulnerable for undernourishment?
A An elderly woman from the southern part of Africa
B A newborn child in the south of Asia
C A pregnant woman in South America

2 Which of the following non-communicable disease group is the most diet-

related?
A Cancers
B Cardiovascular diseases
C Chronic respiratory diseases

3 Double burden of malnutrition is ...

A Coexistence of undernutrition along with overweight and obesity, or diet-related
non-communicable diseases in individuals
B Coexistence of undernutrition along with overweight and obesity, or diet-related
non-communicable diseases within households and populations
C Both

4 A 27 year old lady living in South Africa has recently been diagnosed with Type
2 diabetes related to her BMI of 29. She has also been anaemic for the past 10
years and is having a regular oral iron treatment. In terms of her overall
nutritional status which one of the following describes her best?
A Double burden of malnutrition
B Obesity
C TOFI

5 You are a dietitian appointed to tackle malnutrition in the South Holland region
focusing on children from families with a low-socioeconomic status. Your role is
best described as one at strategic level. Which of the following options would
you include within your role initially?
A Delivering trainings at schools in order increase the nutritional quality of school
foods.
B Developing and implementing of policies and programmes for tackling
malnutrition.
C Run education group classes at your clinic for children and their families to
provide them with basic tips on tackling malnutrition.

6 Global obesity rates are alarming. A number of measures and strategies are
implemented at national and international levels every year. One of these
measures is making nutritional policies. Which one of the policies below targets
obesity?
A Food fortification
B Food labelling
C Food texture manipulation

7 The introduction section of a scientific article is often funnel-shaped. In the

lecture, we discussed some parts of the introduction. Here are three of these
parts (in alphabetic order):
 “aim of the current study” (1)
 “general introduction of the subject” (2)
 “what is not yet known about the problem” (3)
What is the order of these parts in the funnel shaped introduction of a scientific
article?
A 2, 3, 1
B 3, 1, 2
C 1, 2, 3

8 The aim of a researcher is to describe a certain population. What kind of

research design would you suggest?
A Cohort-study
B RCT
C Survey

9 Current research done by the Maastricht UMC (NtvG, D4244) showed that
among the research population of obese primary school kids, 37% was in a pre-
stage of diabetes mellitus type-2. Which of the following is a medical
characteristic of this condition?

A Insulin allergy
B Insulin deficiency
C Insulin resistance

10 What is the proposed molecular and biochemical relationship between

overweight and diabetes?

A Abdominal adipose tissue produces cytokines that interfere with insulin

signaling
B Brown adipose tissue stores energy as triglycerides which affect the pancreas
C Visceral adipose tissue is the only compound that negatively affects insulin
sensitivity
11 What are the effects of the North-American or Western diet on our health
according to the theory of Mayer as proposed in the Brain-Gut connection
book? The contents of the food …

A Contain too much insoluble carbohydrates

B Make the lining of our gut thicker and less permeable
C Negatively affect the composition of our microbiome

12 What is one of the effects of a high fat, high calorie diet on the gastro-intestinal
tract?
A It changes the composition of the microbiome
B It lowers the uptake of glucose and nutrients
C It lowers the risk of irritable bowel syndrom

13 Rank the following products from using ‘less land needed’ to produce to ‘more
land needed’:
-Dairy
-Pork
-Maize
A dairy, pork, maize
B maize, dairy, pork
C pork, dairy, maize

14 Which of the following statements is correct?

A Babies who are big for their age will need solid foods earlier than other babies
B Using solid foods or drinks from a bottle to comfort a baby could lead to
weight problems later in life
C When introducing a baby to solid food it is important to immediately feed at
regular times in order to prevent gastric problems

15 Why is it better NOT to give normal cow's milk to an infant?

A Cow’s milk contains higher concentrations of iron, which may lead to cardiac
problems in young children due to iron overload
B Drinking cow’s milk below 1 year of age may increase the risk of developing
cow’s milk allergy
C The amount of proteins in cow's milk is too high, and may harm the
kidneys

16 Mandy is 9 months old. Which of the following solid foods would you
recommend?
A A slice of brown bread with margarine and a hardboiled egg
B A slice of white bread with butter and honey
C A slice of whole-wheat bread with low fat margarine and liver pâté

17 What type of supplement is officially recommended by the Health Council

(Gezondheidsraad) in the case of an eight-week-old baby who is breastfed?
A 5 microgram vitamin D and 300 microgram vitamin A
B 10 microgram vitamin D only
C 10 microgram vitamin D and 150 microgram vitamin K
18 The Netherlands Nutrition Centre has additional recommendations for pregnant
women next to eating in accordance with the Wheel of Five. In which exact
period do these extra recommendations apply? From…
A The moment that a woman decides to try to become pregnant
B The very first day of pregnancy until the baby has been born
C The 2nd trimester of pregnancy onwards

19 Why should pregnant women avoid eating liver products? Liver products…
A Are naturally high in vitamin A, which may harm the unborn child
B May contain the dangerous bacterium Listeria, which may cause listeriosis
C Tend to contain high concentrations of toxic heavy metals

20 Nutrition policies in schools are important for society because they…

A Create awareness of the obesity problem among parents
B Increase physical activity at schools
C May reduce weight gain in school children

21 Zachary (1.5 years old) is eating cookies. His mother doesn’t want him to eat
too much cookies, so she hides them in a drawer in the kitchen where he
cannot see them. Zachary starts searching for the cookies in the drawer. Which
psychological concept did Zachary already develop?
A Conservation
B Object permanence
C Theory of mind

22 Mary (5 years old) likes to eat potatoes, but she refuses to eat the rest of her
vegetables at dinner. What can her parents do to stimulate her to eat healthier?
A Eat vegetables themselves and show her they enjoy it
B Forbid her to eat too much potatoes
C Reward her with a dessert when she eats her vegetables

23 Karl is 66 years old. What dietary advice (Gezondheidsraad) suits him?

A He will need more protein as compared to young adults
B He will require the same amount of calories, but a lower amount of fat as
compared to young adults
C The recommended amounts for protein and fat are the same as for young
adults, but a lower amount of total calories is advised

24 What are typical symptoms of Age Related Macular Degeneratio

A Blurred vision and seeing straight lines as wavy or crooked
B Feeling physically weaker and having difficulty lifting objects
C Memory loss and being confused about time or place

25 Paul works as a general practitioner. He assumes that Ann Bailey (82 years old)
may suffer from a vitamin B12 deficiency. What are recognisable symptoms of
such a deficiency? The first symptoms of B12 deficiency normally are…
A Dry skin and poor wound healing
B Highly variable symptoms, difficult to recognise and non-specific
C Painful neurological symptoms and numbness of the extremities

26 How does estrogen affect osteoporosis? Estrogen…

A Helps protect against bone loss, by improving the body’s absorption and
retention of calcium
B Increases the number and activity of osteoclasts and this will result in bone loss
and finally lead to osteoporosis
C Inhibits calcium absorption from food, through formation of insoluble compounds
with calcium ions. Inadequate calcium intake will lead to osteoporosis

27 Ben, 32 years old, wants to improve his bone density. What type of exercise on
a daily basis will be the best choice for Ben?
A Biking
B Jumping rope
C Swimming

28 Energy drinks are very popular among young people. Experts say frequent
usage of energy drinks by children is harmful to health and should be limited
through more stringent regulation by prohibiting their sales to children and
adolescents.
Which of the below mentioned ingredient lists is an example of such a potential
harmful energy drink?
A Sparkling filtered water, Apple juice, Cane syrup, Acerola extract, Flavors
(Ginger, Bergamot, Lemon), Natural Colors (Caramel), Citric acid, Ginseng
extract, Mate extract, Green tea extract, Sea salt, Stevia
B Carbonated Water, Sucrose, Glucose, Citric Acid, Taurine, Sodium
Bicarbonate, Magnesium Carbonate, Caffeine, Niacinamide, Calcium
Pantothenate, Pyridoxine Hydrochloride, Guarana seed extract, Vitamin
B12, Natural and Artificial Flavors, Colors
C Water, Sucrose, Glucose, Maltodextrin, Acid (E330), Beta-Carotene, Potassium
Sorbate, Sodium Benzoate, Flavourings, Emulsifiers (Acacia Gum, Glycerol
Esters of Wood Rosins), Sweeteners (Aspartame, Acesulfame K), Vitamins
(Niacin, Pantothenic Acid, B6), Mineral (Potassium Lactate)

29 What makes it difficult to stimulate healthy food choices in early adolescents?

A They are not sensitive to rewards at all
B They have difficulties controlling their impulses
C They refuse to do what the rest of their peers do

30 Many teenagers often drink energy drinks at high school. Which of the following
is the best option to stimulate teenagers to drink more water (instead of energy
drinks) at school?
A Forbid drinking energy drinks at school
B Let teachers provide the right example, by not drinking energy drinks
C Show them that many of their peers drink water

31 What differentiates nudging from intervention mapping? Contrary to intervention

mapping, nudging aims to …
A Add knowledge
B Change automatic behavior
C Create awareness

32 What is a typical outcome of an Intervention Mapping Protocol aiming at skills of

teens on fruit eating?
A Lowering the price of fruit in the school canteen
B Organizing a workshop on smoothie-making
C Putting fruit at eye-level instead of chocolate in the school canteen

33 Historically dietary guidelines were being revised based upon the discovery of
new nutrients such as vitamins and minerals. Later new needs emerged for their
regular improvements. Which of the following reasons do you think is/are
amongst the current needs?
A Emerging health issues such as hidden hunger
B Need for improved visual tools
C All of the above

34 Here are some characteristics of a study design:

 Provides a clear 'snapshot' of the outcome and the characteristics
associated with it, at a specific point in time.
 Results are time-bound and, therefore, give no indication of a sequence of
events or reveal historical or temporal contexts.
 Studies cannot be utilized to establish cause-and-effect relationships

What study design is this most probably?

A Cross-sectional
B RCT
C Systematic-review

35 A researcher analyses the effects of protein supplementation on muscle growth.

In this research, the independent variable is…
A Muscle growth
B Protein supplementation
C The effect

36 Nutrition interventions are presented as business cases/plans to health providers

and commissioners with the purposes of financial investments and logistic
support. What element would you use to increase the likelihood of
commissioners’ investments on your business plan?
A A comprehensive executive summary which includes perceived results of the
intervention
B A detailed financial summary including material and non-material cost of
the intervention
C A firm background scientific research which presents detailed facts and figures
about the topic
37 …………………………… will help you to formulate goals for your project which
will eventually provide the basis for monitoring progress and measuring
outcomes.
How would you fill in the blanks?
A Nutrition assessment
B Nutrition diagnosis
C Nutrition interventions

38 One of the ways to convince your stakeholder to invest in your intervention is to

develop a value for money solution and showcase them the existing interventions
highlighting why there is a need for your intervention. The method used for this is
called…
A Opinion appraisal
B Option appraisal
C Option assessment

39 “Excessive caloric intake (PROBLEM) “related to” frequent number of meals

which are high in fat (EATIOLOGY) “as evidenced by” average daily intake of
calories exceeding recommended amount by 1000 kcal and 4 kg weight gain
in the last 6 weeks (……..).”

Nutrition diagnosis are to set basis for a tailored and effective interventions. On
the example diagnosis above, how would you fill in the blanks referring to the text
written in?
A Phenotypes
B Signs and symptoms
C Underlying factors

40 Nutrition care process is a tool to effectively create nutrition care for individuals
and populations. The diagram below shows the process cycle with its three
components. Which of the following answers completes the cycle?
A Intervention diagnosis
B Nutritional determinance
C Nutritional diagnosis

41 Which letters of RE AIM aim to evaluate the process of a programme?

A A, I and M
B R and E
C R and M

42 If you want to measure the efficiency of your intervention, what kind of

measuring tool is most logical?

A An observational scheme for observing the activities of your intervention

B A topic list for an interview with stakeholders
C A questionnaire for the target group, before and after your intervention

43 Alice designed an intervention for undernutrition in an elderly home in The

Hague. Unfortunately, in her measurement after six months she found no
significant change in BMI and muscle strength. Through interviews among
nurses she found out that the management did not give them extra hours to
carry out the intervention, so the nurses stopped providing the extra protein-rich
snacks to the elderly.
Where in the process did the intervention fail?
A Adoption
B Maintenance
C Reach

44 Here is a table (taken from the results section of a scientific article):

What can you conclude on the basis of this table?

A In comparison to other professions, dietitians have a significantly higher
knowledge score
B In comparison to other professions, dietitians do not have a significantly
higher knowledge score
C In comparison to other professions, dietitians have a significantly lower
knowledge score

45 Below, you see a part of the text of a scientific article.

“The majority of participants were registered dietitians and female. The

areas of study for the highest degree of education included nutrition
(53.8%); public health (11.2%); management (7.7%); medical sciences
(5.5%); and epidemiology (2.4%). Additionally, 18.9% of respondents
indicated that their highest degree was in another (unspecified) field.”

In what section can you, most probably, find this text?

A conclusion
B methods
C results

46 The health care system in The Netherlands is based on…

A The Beveridge model
B The Bismarck model
C The National Health Insurance Model

47 In The Netherlands, how is the Health Insurance Fund (“zorgverzekeringswet”)

funded?
A Both the insured and the government pay for it
B Only the government pays for it
C Only the insured pay for it

48 Janice (40 years old) wants to lose weight, and she started to track her food
intake via an app. What are the benefits of monitoring her food intake?
A It will help her in maintaining a healthy diet on the long term
B She gets more insight into her unhealthy eating habits
C She will have more willpower to resist unhealthy foods

49 What is true about interventions that stimulate healthy behaviors via an app?
A App-based interventions are especially effective for individuals who are
overweight
B Standalone app interventions are more effective compared to combined
interventions
C The effectiveness of app-based interventions is modest

50 What is the best way to increase the likelihood that a person will thoroughly
read a health message you send via a health app?
A Make the message personally relevant
B Provide only information on eating behaviors that are relevant for the target
group
C Send the message to the right target group

51 Here are some parts of a scientific article:

  Research problem and answers (brief)
 Place finding in perspective. Use work of others.
 Analysis unexpected findings.
 Discuss potential limitations and weaknesses
 Concise summary of the principal implications of the findings
 Recommendations for further research
To what section do these parts belong?
A Conclusion
B Discussion
C Results

52 In the conclusion of a scientific article, the researchers state that the

intervention they performed did not have a significant effect. This conclusion fits
in a …
A RCT study
B case control study
C qualitative study

53 The NutriScore FOP labeling system is NOT meant to compare…

A Cornflakes with breakfast bars
B Fruit juice with soda drinks
C French fries with canned tuna fish

54 What will be the order (high to low score: A-B-C-D-E) of the current NutriScores
of the following supermarket products …?:
-Lay’s potato crisps ready salted
-Diet coke (Coca Cola)
-Smoked Salmon (prepacked)
A Diet Coke – Smoked Salmon – Lay’s potato crisps
B Smoked Salmon – Diet Coke- Lay’s potato crisps
C Smoked Salmon – Lay’s potato crisps –Diet Coke

55 Which of the below-mentioned examples of nutrient profiling can be seen as a

Semi-directive FOP label?

Multiple traffic light system

Guideline Daily Allowance

Green Keyhole
 OPEN Questions (35 points)
1 (10 points)

Describe a typical example of…

1. a nudge in a school canteen
2. a social marketing intervention in a school canteen
3. an intervention plan activity in a school canteen

2 (10 points)

QUESTION:
Dietary guidelines are revised and improved regularly. Along with emerging
nutritional concerns and advise, why do you think regular update is necessary,
especially for dietitians?

ANSWER:

3 (15 points)

QUESTION:

a) What is the veil of ignorance? (5 pt)

b) How can the veil of ignorance help to design a fair health care system?
(10 pt)

ANSWER:

a) What is the veil of ignorance? (5 pt)

b) How can the veil of ignorance help to design a fair health care system?
(10 pt)
THE END