Unit 1 – Nutrition Basics

Sample Multiple choice

_____ 1. Which of the following are considered to be “essential” nutrients?a. Water b. Cholesterolc. Linoleic and alpha-linolenic acidd. All the abovee. a and c only

_____ 2. The general term that describes recommended intake levels of nutrients (reference standards) for planning and assessing diets in all healthy persons is:a. Adequate Intake Levels.b. Tolerable Upper Limits.c. Essential Nutrients.d. Dietary Reference Intakes.

_____ 3. The Estimated Average Requirement (EAR) means:a. an intake level that meets the nutrient needs of 98% of healthy people.b. an intake value that meets the nutrient needs of half the healthy individuals in

a group.c. the upper limits of a nutrient compatible with health.d. the nutrient intake standards for healthy people.e. that this is a “tentative” RDA.

_____ 4. The recommended fat intake is _____ of total Calories.a. 20-35%b. <30%c. 40-50%d. ≤45%e. Recommended fat intake is unlimited as long as you choose “healthy” fats to

eat.

_____ 5. Which of the following combinations do NOT represent complete proteins?a. Grains and seedsb. Grains and legumesc. Seeds and legumesd. Soybeans

_____ 6. A food label ingredient list reads: wheat flour, vegetable shortening, sugar, salt, and cornstarch. What item would contribute the greatest amount of WEIGHT in that food?a. Saltb. Sugarc. Wheat flourd. Cornstarche. Vegetable shortening

1

_____ 7. All of the following statements about food labels are true EXCEPT:a. they can be used by consumers to select foods with less fat, sodium, and

cholesterol.b. they appear on almost all multiple-ingredient foods.c. they have standard serving sizes listed.d. they contain information about the amount recommended for ingestion each

day.e. All of the above ARE true.

_____ 8. After class, you go to Jamba Juice and get an “Orange-a-Peel” smoothie that contains the following nutrients: 9 g of protein, 102 g carbohydrate, and 1 g of fat. How many total Calories does this provide? 9+36+a. 299b. 399 c. 448d. 453e. 546

_____ 9. Based on your calculations in question #8, what is the % fat in the meal?a. 2%b. 10%c. 15%d. 20%e. Need more information

_____ 10. Which of the following is NOT true about the development of nutrient deficiencies or toxicities?a. Nutrient deficiencies begin with a prolonged period of marginal dietary intake.b. Cell processes change because of high blood levels.c. Organ functions change and physical signs appear.d. Returning dietary intake to normal can reverse all physical signs.

_____ 11. A 65 year old was buying an iron supplement for her “weak blood.” She asked the pharmacist what amount was the greatest amount of iron she could take every day. What reference standards could the pharmacist use to provide the best recommendation?a. RDAsb. RDIsc. ULsd. EARs

_____ 12. Which of the following vitamin(s) act(s) as antioxidants in the body?a. vitamin Cb. vitamin Ec. beta-carotened. all of the abovee. a and b only

_____ 13. Adults are approximately _____ water by weight.a. 20-30%b. 40-50%c. 50-60%d. 60-70%e. 70-80%

2

_____ 14. The balance of fluids, nutrients, gases, temperature, and other conditions needed to ensure proper functioning of cells is known as:a. regulation.b. homeostasis.c. energy balance.d. cellular respiration.e. none of the above

_____ 15. Secondary malnutrition may be precipitated by:a. a poor diet.b. a disease state.c. a surgical procedure.d. all of the abovee. b and c only

_____ 16. Nutrient dense can be defined as:a. good sources of nutrients that are low in Calories.b. low amounts of nutrients that are high in Calories.c. good sources of nutrients that are high in Calories.d. eating a variety of foods.e. none of the above

_____ 17. Which of the following would NOT be considered one of the four components of nutrition assessment?a. Anthropometric assessmentb. Biochemical testingc. Clinical examinationd. Initial evaluatione. Diet history

_____ 18. Inspection of hair, eyes, skin, and posture is part of the nutrition assessment component known as the:a. diet history.b. anthropometrics.c. biochemical testing.d. clinical examination.e. initial evaluation.

Use the following information to answer questions 19-22.

Jill is a very active teenager who has been maintaining her current weight of 125 pounds. Her average daily macronutrient intake consists of 250 g carbohydrate, 100 g fat, 30 g saturated fat, and 50 g protein.

_____ 19. How many Calories from carbohydrates is Jill consuming daily?a. 750b. 1000c. 1750d. 2250

3

_____ 20. Jill’s percentage of energy intake from carbohydrate is:a. 12%.b. 25%.c. 48%.d. 57%.e. 65%.

_____ 21. Is this within the Acceptable Macronutrient Distribution Range for carbohydrate intake?a. Yesb. No

_____ 22. Jill’s percentage of energy intake from saturated fat is:a. perfect, less than the recommendation of 10%.b. average, at exactly 10%. c. higher than the recommendations at 13%.d. extremely high at 30% of the recommended amount.

_____ 23. Which of the following groups of people would be considered most appropriate to recommend a dietary supplement to?a. Pregnant womenb. People with poor or monotonous dietsc. Lacto-ovo vegetariansd. all of the abovee. a and b only

_____ 24. Which of the following nutrients is considered nonessential? a. vitamin Cb. ironc. cholesterold. potassiume. vitamin E

_____ 25. An example of a functional food would be:a. lactose-free milk.b. “egg beaters.”c. orange juice with vitamin D added.d. all of the above e. a and c only

_____ 26. Which of the following food groups would give a person a high amount of probiotics in their diet?a. Onions, garlic, wheat, barley b. Soy sauce, tempeh, misoc. Buttermilkd. All of the abovee. b and c only

Short Answer Questions1) Primary-Aimed at disease prevention and nutrition awareness-no disease yet

Secondary-Aimed at trying to identify diseases in their early stages and catch those at risk who don’t know they have it or are at risk.Tertiary-Aimed at rehabilitating those who already have the disease and returning them to optimal functioning for them with the disease.

2) Too little nutrients causes deficiencies such as too little Vit C causes bleeding gums and delayed healing of wounds also too little Vit A can eventually cause irreversible blindness. With too little nutrients from the

4

diet the body basically uses up its stores until there is none left. Too much of nutrient causes toxicity as the body/blood gets saturated with these nutrients. For example too much sodium leads to high blood pressure. Basically too much or too little of nutrients causes malnutrition.

3) Grains and recommended that there are about 6-7 grains in the diet, 1 grain is approximately 1 slice of bread or ½ cup of pasta. It is recommended that at least half of the grains in a diet are whole grains. Good for iron, zinc and vit E. Fruits and vegetables are recommended 7-8 per day. 1 should be a dark fruit or veg and the other should be an orange fruit or veg. Fruit and veg is important in lots of nutrients…for example dietary folate comes from dark green leafy veg.

4) The rainbow better shows where the emphasis for the day should be e.g. that the veg and fruit section is bigger, it focuses a lot of physical activity and giving examples of activity, gives clearer examples of the food categories and serving sizes with pictures, the pictures are more diverse and include foods from different ethnic groups.

5

Unit2- AdulthoodSample Multiple Choice

1. The decline in estrogen production in women after menopause leads to all of the following EXCEPT:

a. more acne.b. accelerated loss of bone mass.c. an increase in abdominal fat.d. greater risk of cardiovascular disease.e. All of the above occur with less estrogen.

2. To lose one pound per week, a person would need to eat _____ fewer Calories per day.a. 250b. 300c. 450d. 500e. 1,000

3. Potential health benefits of vegetarian diets include all of the following EXCEPT:a. decreased risk of mortality.b. lower incidence of heart disease symptoms.c. lower risk for type 1 diabetes.d. lower incidence of hypertension.e. decreased risk of colorectal cancers.

4. Unhealthy and potentially harmful diet strategies include:a. inadequate nutrient supplies.b. severe energy restrictions.c. specific food combinations.d. strict limitations.e. all of the above

5. Metabolic rate and energy expenditure begin to decline in early adulthood at a rate of about _____ per decade.a. 2%b. 5%c. 8%d. 10%e. 12%

6. The most variable component of energy expenditure is:a. the thermic effect of food.b. basal metabolic rate.c. activity thermogenesis.d. your sleep habits.e. bone mass.

7. The number of Calories to gain or lose 1 lb body weight is _____.a. 2500

6

b. 3000c. 3500d. 3700

8. Chronic conditions with MODIFIABLE risk factors include which of the following?a. Heart diseaseb. Cancerc. Stroke d. Hypertension e. All of the above

9. The Acceptable Macronutrient Distribution Range for total fat intake daily is _____ of Calories.

a. 10-15%b. 15-20%c. 20-35%d. 35-40%e. 40-50%

10. Based on the Acceptable Macronutrient Distribution Ranges, someone that consumes 2000 Calories per day should aim for _____ fat Calories/day.

a. 200 – 400b. 400 – 700c. 600 – 900d. 1000 – 1200

11. “If you drink, do so in moderation,” is defined as:a. no more than 3 drinks per day for males and no more than 2 for

females.b. no more than 2 drinks per day for males and no more than 3 for

females.c. no more than 2 drinks per day for males and no more than 1 for

females.d. no more than 1 drink per day for males and no more than 2 for females.e. no more than 2 drinks per day for males or females.

12. For women, iron needs drop from 18 mg to _____ per day at menopausea. 4 mgb. 6 mgc. 8 mgd. 10 mge. 12 mg

13. The average daily dietary fiber recommendations are _____ for males and females,respectively.

a. the same at 25 gramsb. 35 and 21 gramsc. 38 and 25 gramsd. 45 and 38 gramse. none of the above

7

14. The cornerstone of successful weight management is:a. a variety of low-calorie foods.b. fat loss.c. muscle preservation.d. long-term lifestyle change.e. initial weight loss.

15. In order to lose 4 pounds in 1 month, you would need to decrease your intake by _____ Calories on a daily basis.

a. 250b. 350c. 500d. 550e. 750

16. Which of the following would NOT be a social determinant of health?a. Transportationb. Stressc. Workd. Unemploymente. These are all social determinants of health

17. Examples of high-iron foods include:a. red meat.b. fortified cereals.c. dried beans.d. all of the abovee. a and b only

Use the following information to answer questions 18-19. Michelle is a 49-year-old, lightly active female who weighs 131 pounds and is 5’8” tall. Females: REE = (10 x weight) + (6.25 x height) – (5 x age) – 161 Sedentary = 1.2Light activity = 1.4Moderate activity = 1.6Very active = 1.1

18. What is Michelle’s resting metabolic rate?a. 1270b. 1500c. 1760d. 2164e. 2340

19. What is Michelle’s estimated daily Calorie expenditure?a. 1500b. 1780c. 1930d. 2100e. 2450

8

20. Which of the following statements would be an example of a fad diet?a. Hot peppers speed your metabolism!b. All foods can fit!c. Exercise 30 minutes per day!d. Grapefruit with every meal helps burn fat!e. Both a and d

21. One serving of Gardetto’s reduced-fat chips and twists snack mix contains 220Calories, with 79 kcal from fat. Therefore, the snack mix derives _____% kcal fromfat.

a. 75b. 50c. 36d. 25e. 5

22. Using the answer from question #21, would this product fit the AcceptableMacronutrient Distribution Range for fat intake?

a. Yesb. Noc. Not enough information to determine

23. The areas of the body affected by cardiovascular diseases include the:a. heart.b. brain.c. blood vessels.d. all of the above

24. Risk factors for cardiovascular diseases include all of the following EXCEPT:a. high triglycerides.b. low low-density lipoprotein levels (LDL).c. high blood pressure.d. low high-density lipoprotein levels (HDL).e. cigarette smoking.

25. Calculate the BMI of a 50-year-old man who is 5’ 11” tall and weighs 200 lb. a. Less than 19b. Between 20 and 24.9c. Between 27 and 29.9d. Greater than 30

26. The man in question #25 would be considered _____ based on his BMI.a. underweightb. normal weightc. overweightd. obesee. extremely obese

9

27. BMI approximates body fat for most healthy individuals; however, BMI measures don’t accurately represent healthy weights for which of the following?a. athletes with a large percentage of muscleb. individuals with little muscle massc. individuals with large, dense bonesd. dehydrated individualse. all of the above

28. Overweight and obesity are associated with an increased risk of which of the followingconditions?

a. sleep apneab. gallbladder diseasec. type 2 diabetesd. osteoarthritise. all of the above

29. For a moderately overweight female, a realistic weight loss goal is to lose 0.5 to 1.0 lb/week. What is the daily Calorie deficit necessary to lose 0.5 lb/week?a. 150b. 200c. 250d. 300

30. All of the following are good criteria for a weight-loss program EXCEPT _____.a. includes regular exerciseb. offers realistic weight loss goalsc. offers problem-solving solutions to dietary practices that can be followed over a

lifetimed. costs a lot of money and usually not offered to low-income families

31. Metabolic syndrome is related to a cluster of metabolic abnormalities that include:a. elevated fasting blood glucose levels ≥110 mg/dL.b. high levels of central body fat.c. high blood insulin levels.d. low levels of HDL cholesterol.e. all of the above

1) Food security is based on food availability (sufficient and consistent food supply), food access (sufficient resources to get food and to get the right food) and food use (Basic knowledge of nutrition care, sanitation and water).

2)135lbs / 2.2=61.36 5’6=66in x 2.54=167.64/100=1.6764=2.81 61.36/2.81=21.8. This is within the healthy range of 18.5-24.5 which means my weight is about normal.3) Energy in-portion size, increased use of fast foods, eat more often, drink soft drinks.Energy out-longer distances to travel, building design, increased sedentary activities, labour saving devices.4) Recommended 30-60mins of activity a day. If not active you should start but start slow. Light effort is things like walking, bowling about 60mins needed etc Moderate is cycling or swimming which is 30-60mins needed. Vigorous is running etc which is 30mins per day.

10

Unit 3- PreconceptionSample Multiple Choice

_____ 1. The first half of the menstrual cycle is called the _____.a. follicular phaseb. luteal phasec. estrogen phased. primordial phasee. none of the above

_____ 2. Ovulation results from a surge in the hormone _____. a. estrogenb. progesteronec. luteinizing hormoned. follicle stimulating hormonee. gonadotropin releasing hormone

_____ 3. The leading diagnosis related to infertility is _____.a. endocrine abnormalities that modify hormonal regulation of fertilityb. excessive exercise in womenc. environmental contaminants such as lead and mercuryd. obesity in mene. all of the above are leading diagnoses

_____ 4. Which of the following factors would NOT be related to infertility in women?a. High alcohol intakeb. Excessive exercisec. A strict vegetarian dietd. Having a flu virus and not eating for a day

_____ 5. Which of the following nutrition factors would NOT be related to infertility in men?a. Following a weight-loss diet that resulted in body weight 15% below normalb. Eating a diet containing animal productsc. High alcohol intaked. An inadequate intake of antioxidantse. an inadequate intake of zinc

_____ 6. All of the following factors have been related to impaired fertility in males EXCEPT:a. high sperm count.b. steroid abuse.c. estrogen exposure.d. excessive heat to testes.e. chromosomal abnormalities in sperm.

_____ 8. Fertility is often compromised in women with a body mass index (BMI) < _____ and > _____.a. 18/35b. 20/30c. 25/40d. 30/50e. 35/55

11

_____ 9. The best recommendation to give an underweight woman with amenorrhea is _____.a. start exercisingb. gain weight c. see a health care provider to obtain a medical prescription that helps with

fertilityd. none of the above

_____ 10. Which of the following dietary components has NOT shown a relationship to impaired fertility in women?a. regular intake of soy foodsb. low fat intake (<20%)c. alcohol d. caffeinee. vitamin E

_____ 11. Decreased fertility in men is related to sperm _____.a. numberb. motilityc. morphologyd. a and ce. a, b, and c

_____ 12. Which of the following is NOT related to oral contraceptive use?a. Weight lossb. Increased blood levels of HDL cholesterol (the “good” cholesterol)c. Increased risk of blood clotsd. Increased levels of triglycerides and LDL cholesterol (the “bad” cholesterol)e. Decreased blood levels of vitamin B12

_____ 13. The recommended daily intake of folate for ALL women who may become pregnant is:a. 40 mcg.b. 40 mg.c. 400 mcg.d. 400 mg.e. 400 g.

_____ 14. In order to reduce the incidence of spina bifida and neural tube defects prior to conception, women should eat _____.a. fortified breakfast cerealb. fruits and vegetablesc. refined grain cerealsd. a and be. a and c

12

_____ 15. Which of the following nutrient exposures before and in early pregnancy would NOT disrupt fetal growth and development?a. A decrease in folate b. An increase in vitamin Cc. An increase in leadd. A decrease in iodine

_____ 16. Nutritional exposures before and very early in pregnancy may disrupt fetal growth and development. Which of the following would NOT be considered an adverse nutritional exposure?a. iodine deficiencyb. obesityc. alcohol intaked. poorly controlled glucosee. All of the above would be considered adverse nutritional exposures.

_____ 17. The primary effect(s) of chronic undernutrition on reproduction in women is/are:a. high likelihood of death in first year.b. the birth of small and frail infants.c. spina bifida or other NTDs.d. all of the abovee. Both a and b

____ 18. What are potential consequences of delaying conception until you are in your 40s?a. Decreased chance of conceptionb. Sperm become less viablec. Higher likelihood for chromosomal abnormalitiesd. All of the abovee. b and c only

_____ 19. During periods of under-nutrition when leptin secretion decreases, there is also a decrease in the production of GnRH (gonadotropin releasing hormone); this would result in:a. a decrease in the production of FSH and LH.b. a lack of follicular development.c. the absence of ovulation.d. all of the abovee. a and b only

_____ 20. Your best friend is pregnant and asks you to recommend foods that will increase her iron stores. Which of the following would be the best choice?a. Oatmeal b. A hamburger with tomato slicesc. Canned spinachd. Seasonal fruite. Frozen peas

13

_____ 21. Preventive efforts to improve health in women prior to conception include all of the following EXCEPT:a. reducing the amount of energy expended to promote optimum nutrient stores.b. improving quality of diet. c. stopping tobacco, drugs, and alcohol.d. reducing stress.e. All of the above WOULD be considered preventive efforts.

_____ 22. Jane is 30 and has a BMI of 35; she and her husband have been trying to get pregnant for over a year, but she is not ovulating. Why would her doctor recommend weight loss and exercise instead of prescribing medication to induce ovulation?a. At 30 years old, it is too risky to prescribe medicationb. There are no medications on the market that induce ovulationc. She is overweight and needs to have a BMI <25 before conceivingd. Drugs that induce ovulation are less effective in obese womene. It is unsafe to try and conceive when you are not physically active

_____ 23. _____ is the first therapeutic option for infertility in obese people.a. Medicationb. Weight lossc. Hormone therapyd. In-vitro fertilizatione. Need more information.

_____ 24. An eating disorder that affects fertility is _____.a. celiac diseaseb. anorexia nervosac. bulimiad. b and c

_____ 26. Diets developed for people with type 2 diabetes include all of the following EXCEPT:a. weight loss if overweight.b. at least half of grain servings from whole-grain sources.c. fiber-rich food sources.d. 150 minutes per week of physical activity. e. ≤40% of total intake from saturated fats.

_____ 27. The most effective approach to weight loss in people with diabetes so far is:a. drug therapy and weight loss.b. drug therapy and exercise.c. reduced caloric intake and exercise.d. behavioral therapy.

_____ 28. The glycemic load of a food is:a. a measure of the extent to which 50 grams of carbohydrate-containing foods

raise blood glucose compared to 50 grams of glucose or white bread.b. obtained by multiplying the GI of a food by the grams of carbohydrate

contained in the food, and then dividing it by 100.

14

c. how fast your blood sugar rises after eating a mixed meal containing 65% carbohydrate.

d. measured by how much insulin is released from the pancreas after a high-carbohydrate meal.

e. all of the above

_____ 29. A symptom NOT related to PCOS is _____.a. insulin resistanceb. amennorheac. infertilityd. low testosterone levels

_____ 30. Clinical signs associated with polycystic ovary syndrome (PCOS) include:a. insulin resistance.b. infertility.c. obesity.d. excess abdominal fat.e. all of the above

_____ 31. The primary GOAL of the treatment of PCOS is:a. to increase insulin sensitivity.b. to induce weight loss if overweight.c. to regulate blood lipid levels.d. to reverse infertility.e. All of the above are considered to be primary goals.

_____ 32. Dietary recommendations for women with PCOS emphasize:a. whole grains, fruits, and vegetables high in fiber.b. marine sources of the omega-3 fatty acids.c. high-glycemic index carbohydrate sources.d. all of the abovee. a and b only

1)The dietary version is subject to heat damage, prone to oxidative cleavage and is less absorbed compared to synthetic folate. ….not sure look up slides2)The Fertility Diet is a diet that suggests that through diet and exercise we can increase fertility or reduce infertility or bring back fertility. Recommends drink high fat dairy products, take a multivitamin, if you are not active start exercising even if it is only in small amounts such as 10minutes a day. Do not overdo it. 3) How processed the food is, how cooked/long cooked, amount of simple carbs in the food, what it is consumed with etc. 4)It is vital to fetal development with the first few weeks probably even before the pregnancy is detected. It is a critical period so if the nutrient is deficient then then you cannot make it up/ fix the defects later on. May cause low birth weight and preterm delivery. It is really important for neural tube development so if it is not taken sufficiently then neural tube defects such as spinda bifada can occur. 5)Polycystic ovarian syndrome. Cause is uncertain but some symptoms are obescity, high levels of abdominal fat, insulin resistance, irregular periods, polycystic ovaries, high testosterone. The high testosterone causes bad eggs, cysts reduce ovulation and irregular periods means you may not ovulate at all.

15

Unit 4- PregnancySample Multiple Choice

_____ 1. A pre-term birth rate is defined asa. births <30 weeks/100 live births.b. births <32 weeks/100 live births.c. births <37 weeks/100 live births.d. births <37 weeks/1000 pregnancies.

_____ 2. Infants weighing _____ are least likely to die within the first year of life.a. 5 lbs 11 oz to 6 lbs 5 ozb. 6 lbs 10 oz to 7 pounds 2 ozc. 7 lbs 12 oz to 10 lbsd. 8 lbs 8 oz to 10 lbs 2 oz

_____ 3. The preferred source of fuel for the fetus is _____.a. glucoseb. fatty acidsc. proteinsd. sucrosee. all of the above

_____ 4. In the second maternal phase, which statement is NOT correct about hormones and carbohydrate metabolism?a. Rising levels of hCS and prolactin from the pituitary inhibit the conversion of

blood glucose to fat storage.b. Insulin resistance builds and increases the reliance on fats for energy. c. Estrogen and progesterone levels continue to increase and stimulate insulin

production.d. hCG levels increase greater than first phase and convert glucose to glycogen

and fat.

_____ 5. The change in lipid blood levels that occurs during pregnancy can best be explained as _____.a. cholesterol and triglyceride levels decrease due to the increased water volume

in the bloodb. cholesterol and triglyceride levels remain the same as pre-pregnancy levelsc. cholesterol and triglyceride levels increase dramatically from pre-pregnancy

levelsd. cholesterol and triglyceride levels fluctuate daily and depend on when the fetus

is building nerve cells

_____ 6. When cell size increases due to an accumulation of protein and lipids, the increase is characterized as _____.a. hyperplasiab. hypertrophyc. hyperplasia and hypertrophyd. maturation

16

_____ 8. A critical period of neural tube development following conception is:a. 1-2 weeks after conception.b. 2-3 weeks after conception.c. 3-4 weeks after conception.d. 4-5 weeks after conception.

_____ 9. Research is emerging that suggests pregnant women should increase their food sources of docosahexaenoic acid (DHA). Which of the following foods would provide the most DHA to pregnant women?a. ½ tuna salad sandwichb. ¼ cup granola containing 1 tsp sunflower seedc. 8-oz glass whole milkd. 1 cup broccoli

_____ 10. The first half of pregnancy is considered the “maternal _____,” while the second half of pregnancy is considered the ”maternal _____.”a. anatomic phase/catatonic phaseb. catatonic phase/anatomic phasec. catabolic phase/anabolic phased. anabolic phase/catabolic phasee. a and c

_____ 11. A pregnant woman in the anabolic phase of pregnancy a. becomes thirsty and drinks more water.b. notices a significant 1 lb/ week weight gain.c. avoids eating too many calories because the nutrients aren’t needed until the

catabolic phase.d. is more fatigued because of hormone changes.e. a and d only.

_____ 12. Hemodilution of nutrients occurs during pregnancy because:a. women aren’t getting as many nutrients as they did before pregnancy.b. blood volume increases so much.c. amniotic fluid displaces many nutrients.d. the kidneys are filtering nutrients out and then excreting them.e. all of the above

_____ 13. Wide improvements in _____ have corresponded to greater reductions in infant mortality, while small improvements in infant mortality in the past few decades are largely due to _____. a. technical advances in medical care; infectious disease control and sanitationb. infectious disease control and sanitation; industrial revolutionc. infectious disease control and sanitation; technical advances in medical cared. wide spread vaccinations: infectious disease control and sanitation

17

_____ 14. Natality statistics are defined as:a. a mirror of the population’s general health.b. vital statistic data related to pregnancy outcomes.c. a predictor of the next generation’s health.d. important measures of a nation’s wellbeing.

_____ 15. Small for gestational age (SGA) is different than low birth weight because:a. low birth weight is <2500 g (5 lb 8 oz), while SGA is ≤10th %tile for gestational

age.b. SGA is <2500 g (5 lb 8 oz), while low birth weight is ≤10th %tile for gestational

age.c. SGA is <1500 g (3 lb 5 oz), while low birth weight is ≤10th %tile for gestational

age.d. SGA is ≤10th %tile for gestational age, while low birth weight is <1500 g (3 lb 4

oz).

_____ 16. A baby born to a single mom who lost her job and experienced a severe food shortage at the end of her pregnancy will more likely be classified asa. very small for gestational age (vSGA).b. disproportionately small for gestational age (dSGA).c. proportionately small for gestational age (pSGA).d. appropriate for gestational age (AGA).

_____ 17. Why must volume expansion occur BEFORE maternal nutrient stores accumulate?a. in order to support large gains in fetal weight b. in order to provide fetus with sufficient energy, nutrients, and oxygenc. in order to provide mother plenty of fluidsd. to dilute the high concentration of nutrients in pregnant womene. b and c only

_____ 18. Which of the following is a major function of the placenta?a. Hormone and enzyme productionb. Nutrient and gas exchange between mother and fetus c. Removal of waste products from fetusd. Barrier to drugs and alcohole. a, b, and c

_____ 19. When nutrient concentration in the fetal blood is greater than nutrient concentration in maternal blood, nutrients would likely be transferred via:a. passive diffusion.b. facilitated diffusion.c. active transport.d. pinocytosis.e. a and b

18

_____ 20. Decreased conversion of glucose to glycogen and fat, lowered maternal utilization of glucose, and increased liver production of glucose help:a. ensure the mother does not gain excessive weight the second half of

pregnancy.b. ensure a constant supply of fat for maternal energy needs.c. ensure a constant supply of glucose for fetal growth and development.d. ensure that women do not expend too much energy on metabolism and have

plenty of energy to support fetal growth.e. a and d

_____ 21. Factors associated with reduced fetal growth include:a. pre-pregnancy underweight and shortness.b. high-carbohydrate diets.c. low weight gain during pregnancy and poor dietary intake.d. high weight gain during pregnancy.e. a and c

_____ 22. Factors related to infants large for gestational age (LGA) include:a. pre-pregnancy obesity.b. excessive weight gain during pregnancy.c. poorly controlled diabetes in pregnancy.d. all of the abovee. a and b only

19

_____ 23. It is recommended that woman consume a MINIMUM _____ of carbohydrate during pregnancy to meet fetal needs for glucose.a. 125 grams per dayb. 150 grams per dayc. 175 grams per dayd. 225 grams per daye. 250 grams per day

_____ 24. If taken on an EMPTY stomach, folate supplements are nearly _____ bioavailable.a. 45%b. 60%c. 75%d. 85%e. 100%

_____ 25. During pregnancy, as the dose of iron _____ the amount of iron absorbed from supplements _____.a. decreases, increasesb. increases, decreasesc. doubles. triplesd. triples, doublese. none of the above

_____ 26. Iron is absorbed best when: a. you take a separate iron supplement (not in a multi-vitamin).b. you have a higher need for iron.c. you eat meat, poultry, or fish. d. all of the abovee. b and c only

Use the following information to answer questions 27-28: Jane is 5’7” (1.70 m) and weighs 160 pounds (72.7 kg).

_____ 27. What is Jane’s body mass index?a. 19.7b. 25.1c. 31.4d. 43

_____ 28. Based on her BMI, Jane would be considered:a. underweight.b. normal weight.c. overweight.d. obese.e. morbidly obese.

20

_____ 29. Pregnancy increases the absorption of _____ and _____.a. iron b. calciumc. zincd. a and be. b and c

_____ 30. Low weight gain in the 2nd or 3rd trimester increases the risk of:a. spina bifida.b. intra uterine growth retardation (IUGR).c. a macrosomic baby.d. cleft palate.e. all of the above

_____ 31. The recommended dietary allowance for folate during pregnancy is:a. 200 mcg from fortified food or supplements.b. 400 mcg from fortified food or supplements.c. 600 mcg total with 400 mcg from fortified food or supplements.d. 800 mcg total with 600 mcg from fortified food or supplements.e. 4000 mcg total in any form.

_____ 32. Hypertension is defined as having a blood pressure of _____.a. ≥120 mm Hg systolicb. ≥140 mm Hg systolicc. ≥90 mm Hg diastolicd. ≥70 mm Hg diastolice. b and c

_____ 33. Pregnancies among women with blood pressure ≥160/110 mm Hg are associated with an increased risk of:a. fetal death.b. preterm delivery.c. macrosomic infants.d. all of the abovee. a and b only

_____ 34. Preeclampsia-eclampsia represents a syndrome characterized by all of the following EXCEPT:a. blood vessel spasms and constriction.b. increased calcium excretion.c. oxidative tissue damage and inflammation.d. platelet aggregation and blood coagulation.e. All of the above are characteristics of preeclampsia.

_____ 35. Women with which of the following characteristics are at risk of developing preeclampsia?a. Obesityb. Insulin resistancec. First pregnancyd. All of the abovee. a and b only

21

_____ 36. Ideally, when should dietary intervention for preeclampsia begin?a. prior to pregnancyb. prior to the development of eclampsiac. prior to the 20th week of pregnancyd. after diagnosis of preeclampsiae. b and d only

_____ 37. Nutritional and physical activity recommendations that may benefit women at risk for preeclampsia include all of the following EXCEPT:a. 30000 mg calcium.b. 5 or more servings of fruits and vegetables.c. strenuous exercise.d. consumption of low glycemic index vs. high glycemic index carbohydrate foods.e. a and c

_____ 38. Which nutrients appear to reduce or prevent preeclampsia?a. Calcium and magnesiumb. Calcium and fatty oils (n3 fatty acids)c. Calcium and vitamin Cd. Fatty oils (n3 fatty acids) and vitamin E

_____ 39. High maternal blood glucose levels cause the fetus to _____.a. increase insulin outputb. convert glucose into triglycerides and store it as fatc. potentially develop type 2 diabetes later in lifed. all of the abovee. a and c only

_____ 40. _____ of mothers who develop gestational diabetes will develop type 2 diabetes after 5 years.a. 10%b. 20%c. 25%d. 50%

_____ 41. Glucose screening is recommended for women at high risk of developing gestational diabetes during pregnancy. Which of the following would NOT be considered a characteristic of a high-risk woman?a. Caucasian raceb. Obesityc. History of glucose intoleranced. Previous macrosomic infante. All of the above would be considered characteristics of high risk

_____ 42. Glucose screens are not recommended for women at low risk of developing gestational diabetes during pregnancy. Low-risk women include:a. women age <25 years old.b. those with normal prepregnancy weight.c. those with no prior poor obstetrical outcomes.d. all of the abovee. b and c only

22

_____ 43. The PRIMARY approach to treatment of gestational diabetes is to normalize blood glucose levels with _____.a. oral medicationsb. insulin injections or an insulin pumpc. a low-calorie, high-protein dietd. medical nutrition therapy focusing on diet and exercisee. all of the above

_____ 44. Sulfonylureas CANNOT be used in pregnancy because:a. they cross the placenta and may be toxic to the fetus.b. they cross the placenta and interfere with nutrient absorption.c. they cross the placenta and block gas exchange.d. they cross the placenta and stimulate fetal insulin production.e. all of the above

_____ 45. Women with gestational diabetes should aim at a range of _____ fat Calories during pregnancy.a. 10 – 30%b. 15 – 25%c. 30 – 40%d. 40 – 50%e. <35%

23