Download MNT II Midterm Exam Questions With Complete Solutions: Nutrition and Oral Health and more Exams Nursing in PDF only on Docsity!
MNT II Midterm Exam Questions With Complete Solutions · Best practice for nutritional care of transgendered patients Correct Answers gender affirming communication? · Foods with low cariogenic potential are high in which nutrients? Correct Answers protein? calcium and phosphorous? · How are comparative standards used within the NCP? Correct Answers to evaluate the overall impact of the nutrition intervention on the client's nutrition diagnosis(es) and health outcomes. *Challenges and possible solutions related to lactation for transgender women or transfeminine individuals: Correct Answers ⚬initiation of milk production ⚬establishing milk supply ⚬protocols for initiating milk production used for cisgender, non birthing women ￭specific doses of estrogen and progesterone ￭use of galactagogues ￭frequent pumping to stimulate pro lactation hormones ⚬anti-androgen agent to suppress testosterone *Define aging or "uncoupling" in terms of bone structure and physiology Correct Answers bone resorption precedes and exceeds bone formation
*Factors affecting carcinogenicity of foods Correct Answers form and consistency, exposure, nutrient composition, sequence and frequency of eating *Possible solutions for those practicing "chest" binding and for those who have undergone chest masculinization Correct Answers ⚬consider binding for shorter periods of time or taking frequent breaks ⚬use less pressure when binding ⚬wait to bind until they've established a steady supply of milk ⚬molding and cupping of existing chest tissue using "sandwich" method ⚬use of nipple shield ⚬galactagogues ⚬supplemental nursing aids *What are some challenges related to lactation for transgender men or transmasculine individuals? Correct Answers ⚬swelling of breast tissue r/t milk production ⚬establishing adequate latch and milk supply ⚬blocked ducts, mastitis, and/or reduced milk supply ⚬ ↓ prolactin levels, ↓ milk supply, release of excess testosterone in milk supply ⚬swelling of breast tissue r/t milk production ⚬establishing adequate latch and milk supply ⚬blocked ducts, mastitis, and/or reduced milk supply ⚬ ↓ prolactin levels, ↓ milk supply, release of excess testosterone in milk supply
⚬CHEWING SUGARLESS GUM AFTER
EATING/DRINKING CARIOGENIC FOODS
⚬Having sweets with meals rather than as snacks cariogenic Correct Answers *foods (caries-promoting properties of a diet or food) - depends on form, nutrient composition, when it's eaten, duration of exposure to tooth, & frequency with which it's eaten contain fermentable CHO's; when in contact w microorganisms can cause drop in pH to <5.5 & stimulate caries process. cariostatic Correct Answers *⚬don't contribute to decay; aren't metabolized by microorganisms; don't cause drop in salivary pH to < 5.5 w.i 30 min ■Protein foods (eggs, fish, meat, poultry), most veggies, fats, sugarless gum cause of hypoglycemia in patients who have had a gastrectomy Correct Answers late dumping (1-3 hours postprandial, after a meal) d/t rapid digestion and absorption of sugars, elevation of insulin levels, and subsequent decline in blood glucose Changes in ________ __________ can alter fit of dentures and should be monitored. Correct Answers ⚬Changes in body weight can alter fit of dentures - monitor recent wt changes Cheese is considered to be anticariogenic because it: a. induces an alkaline saliva.
b. induces an acidic saliva. c. induces a neutral saliva. d. decreases saliva production. Correct Answers a. induces an alkaline saliva. Common Latex-Fruit or Latex-Food Syndrome allergen Correct Answers banana (avocado, kiwi, mango, chestnut) Deficiencies of what contribute to different oral disorders? What are some examples of oral disorders? Correct Answers (riboflavin, folate, B12, C, Fe, Zn) Periodontal disease Oral cancer Diagnosing food allergy Correct Answers ○Requires identification of the suspected food, proof that ingestion causes the adverse response, and verification of an immune or nonimmune-mediated response ○Detailed food and symptom record - also a diagnostic tool ○Appropriate immunologic testing by physician ■Not completely definitive - use in conjunction w/ physical exam, history, and nutrition assessment SKIN PRICK TEST SERUM ANTIBODY TEST ELIMINATION PHASE FOLLOWED BY CHALLENGE PHASE dietary guidelines after a Nissen fundoplication Correct Answers start clear liquid diet after surgery, consume small and
○Not recommended for formula-fed or breastfed infants in fluoridated communities if drinking water bw feedings ○If exclusively breastfed infant doesn't drink water bw feedings or drinks bottled water, fluoride supp is recommended food allergy definition Correct Answers •an adverse health effect arising from SPECIFIC IMMUNE RESPONE that occurs reproducibly on exposure to a given food Food allergy immune system basics Correct Answers •Antibodies = specialized immune proteins produced in response to introduction of an antigen ⚬REFERRED TO AS IMMUNOGLOBULIN (IG) ⚬5 distinct classes: IgA, IgD, IGE, IgG, IgM •Antigen = an allergen, toxin, or foreign substance IgE IS THE MOST COMMON ANTIBODIES INVOLVED IN FOOD ALLERGIES. Food intolerance definition Correct Answers •an adverse reaction to food or food component that lacks an identified immunologic pathophysiology Food-related factors that play a role in allergies Correct Answers ○Modern westernized diet; prenatal, perinatal, and maternal nutrition; food matrix; cooking temp; etc. For treating Eosinophilic Esophagitis (EoE), many people utilized...? What is it? Correct Answers ○Step up 2-4-6-food elimination diets
■Begins with a two-food (cow's milk and wheat/gluten) elimination diet ■If after 6 wks, no remission of symptoms → start four-food elimination diet (cow's milk, wheat/gluten, egg, and soy) ■If still no resolution → implement six-food elimination diet (SFED; cow's milk, wheat/gluten, egg, soy, peanuts/nuts, and fish/seafood) ■See Box 26.4 for more specific guidelines gastric vs duodenal ulcers Correct Answers gastric: low acid output duodenal: increased acid secretion GI affects of smoking relating to GERD Correct Answers ●Smoking - ↓ LES (lower esophageal sphincter) pressure, ↓ salivation -> prolonged acid clearance health disparities among transgender patients Correct Answers •Poverty, Homelessness, and Unemployment ⚬achieving housing and employment may be challenging due to gender-based stigma & discrimination ⚬15% unemployment (3x general adult population) ⚬29% poverty rate (2x general adult population) ⚬30% have reported being homeless at some point ⚬avoidance of services like homeless shelters
- Mental Health Conditions and Substance Abuse ⚬Psychological distress stemming from stigmas ￭increased risk for substance abuse, depression, and suicidality
In regard to the nutrition care process (NCP), how should you express data for transgenders? Correct Answers As a range between the female and male values (if transition has not taken place, use sex assigned at birth) In terms of exercise, what form of exercise works to prevent osteoporosis and fractures? Correct Answers ■Resistance training (2-3 times/wk) Individual factors that play a role in allergies Correct Answers ⚬Age, genetics & epigenetics, early life factors, immunocompetence, microbiome, use of medications, underlying disease, chronic stress, etc. medical management for gastroparesis Correct Answers ●Tx to promote gastric motility: METOCLOPRAMIDE (+ erythromycin) MNT for gastroparesis Correct Answers pureed, liquified diets (low fat, low fiber foods, light physical activity after eating, avoid meds that slow gastric emptying, small and frequent meals) Most Common IgE-Mediated Food Reactions! Correct Answers ■Fish ■Shellfish ■Wheat ■Soy ■Cow's milk ■Eggs
■Peanuts ■Tree nuts Most studied Eosinophilic Gastrointestinal Diseases; what are they characterized by? Correct Answers ■Eosinophilic esophagitis (EoE) Eosinophilic gastroenteritis (EGE) infiltration of the esophagus, stomach, or intestines w/ eosinophils Non-IgE Mediated Reactions are caused by... Correct Answers •Caused by a reaction involving other components of the immune system APART FROM IgE antibodies Nutrition Assessment of someone with food allergies/intolerances Correct Answers First: detailed clinical history Anthropometrics NPFE Nutrition care for infants/toddlers and preventing dental caries Correct Answers ■Modify frequency/content of daytime bottles (water, formula, or milk only) DON'T PUT BABY TO BED W/BOTTLE ■Clean teeth & gums with gauze pad/washcloth after bottle feedings ■Wean children from bottle by 1 year of age ■Try to make between-meal snacks cariostatic; follow cariogenic foods w/ tooth brushing or rinsing mouth
(■Medications ■Disease - celiac dx, anorexia nervosa, CKD, IBD, DM, etc. ■Lifestyle factors - poor dietary habits ■Genetics) RD recommendations for xerostomia Correct Answers moist, soft foods w/o added spices sticky, dry, crumbly, chewy foods such as crackers and peanut butter may cause problems. Reasons for nutrition recommendations for reducing symptoms of GERD Correct Answers ... Lower EPS pressure? epigastric pain syndrome? Root surface caries vs. lingual caries Correct Answers Root Surface ■root surfaces of teeth secondary to gingival recession - seen in elderly, lack of fluoridated water, poor oral hygiene, ↓ saliva Lingual ■Lingual caries - on lingual side of anterior teeth (surface next to or toward the tongue) - seen in GI reflux, bulimia, anorexia- bulimia Surgery for severe GERD not responding to medical therapy.... Correct Answers undergo Nissen fundoplication surgery Symptoms of dyspepsia Correct Answers epigastric discomfort, (fullness or burning after meals, early satiety)
The Food Allergen Labeling and Consumer Protection Act requires that... Correct Answers Top 8 allergens must be clearly listed The nutrition diagnosis is used to... Correct Answers describe alterations in the patient's nutritional status This type of health care service provides a "one stop shop" approach to maintain patient care within a given medical ecosystem. a.Health Maintenance Organization (HMO) b.Preferred Provider Organization (PPO) c.Integrated Delivery System (IDS) d.Point of Service (POS) Correct Answers c.Integrated Delivery System (IDS) Three examples of risk factors for developing osteoporosis Correct Answers -Relative energy deficiency -cigarette smoking -ethnicity: white or Asian treatment for peptic ulcers include Correct Answers H blockers (H2 blockers increase risk of B12 deficiency) True or false: protein MAY have positive effect on bone Correct Answers true (but it might also not be...? inconclusive research) True or false: Transgenders are at an increased risk for food insecurity. Correct Answers True
-increase erythropoiesis What are the criteria for an osteoporosis (and osteopenia) diagnosis on a dual-energy x-ray absorptiometry (DEXA) scan? Correct Answers ■Osteoporosis: BMD T-score 2.5 SD below the mean (■Osteopenia: BMD T-score 1 to 2.5 SD ■Normal: within 1 SD) What are the three domains of the nutrition care process? Which one of these domains is always prioritized? Correct Answers Intake, clinical, behavioral Intake What are the two types of bone tissue? Correct Answers cortical (compact) and trabecular ... exists in the ends of long bones (cancellous) ⚬Cortical (compact) bone tissue = 80% of skeleton ■Dense outer surface of bone ■Forms protective layer around internal cavity ■Slower remodeling ⚬Trabecular (cancellous) bone tissue = 20% of skeleton ■Exists in the knobby ends of long bones, iliac crest of pelvis, the wrists, scapulas, and vertebrae ■Spongy and less dense than cortical bone ■Loss of trabecular bone tissue late in life is largely responsible for fractures (especially spine)
What do PFAS & LTPS stand for? Correct Answers ○Pollen- food allergy syndrome (PFAS) & Lipid transfer protein syndrome (LTPS) What does FODMAPS stand for? Correct Answers Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols What does PES stand for? Correct Answers problem, etiology, signs and symptoms What does the intervention step of the NCP entail? Correct Answers •Purpose: to improve the condition of the patient's nutrition diagnosis •Purposefully planned actions •Includes interventions such as: ⚬Food and/or nutrient delivery ⚬Nutrition counseling ⚬Nutrition education ⚬Coordination of nutrition care •Nutrition diagnosis & etiology should determine the selection of a nutrition intervention
a. An African American woman who was normal age at menopause and has a large frame and poor intake of calcium. b. A White woman who is overweight, had multiple pregnancies and late menopause, and consumes alcohol. c. A White woman who is underweight, had premature menopause, does not exercise, and smokes cigarettes. d. An Asian woman who is premenopausal and has a large frame, a high calcium intake, and a sedentary lifestyle. Correct Answers a. A White woman who is underweight, had premature menopause, does not exercise, and smokes cigarettes. Which of the following is not associated with dyspepsia? a.Abnormal gastric emptying b.Diet c.Being underweight d.Upper abdominal discomfort Correct Answers c.Being underweight While a dietitian's services may be covered under this type of health-care delivery system, and the patient may see any practitioner they wish, the patient may be required to file reimbursement after services have been rendered, especially with out of network providers. a.Health Maintenance Organization (HMO) b.Preferred Provider Organization (PPO) c.Integrated Delivery System (IDS) d.Point of Service (POS) Correct Answers b.Preferred Provider Organization (PPO) Why does dairy have low cariogenic potential? Correct Answers ■d/t high content of protein, calcium, and phosphorus)
