NCP specifications

Question 1

?: reinforcement of basic/essential nutrition related knowledge

Answer 1

Nutrition Education

Question 2

?: nutritional diagnostic, therapy, and counseling services for purpose of disease management aided by RDN

Answer 2

MNT (Medical Nutrition Therapy)

Question 3

?: done at entry point into the NCP and can be done by RDNs or other professionals (nurses)

Answer 3

Screening/referrals

Question 4

Common Nutrition screening tools:

Answer 4

• Malnutrition universal screening tool (MUST)
• Mini nutritional assessment (MNA)
• Geriatric nutritional risk index (GNRI)

Question 5

?: developed in 2004 used across healthcare to assess malnutrition quickly (wt, ht, BMI, unintentional wt loss, change in nutrition intake >5 days)

Answer 5

MUST

Question 6

?: used in older adults and assesses oral intake, wt loss, mobility, neurological/psychological status, current stress levels, BMI

Answer 6

MNA

Question 7

?: older adults relies on changes in current body wt, previous body wt, and serum albumin

Answer 7

GNRI

Question 8

The Joint commission:

Answer 8

• Mandates hospital have system set in place to specify who should conduct nutrition screenings, on which patients, and which timeframe
• specify hospital should decide what patient needs/conditions warrant nutrition screening
• mandate nutrition screening performed within 24 hrs of inpatient admission

Question 9

Referrals in nutrition education:

Answer 9

RDN advertise nutrition classes where pt can sign up

Question 10

Referrals in MNT:

Answer 10

written referral from physician specifically for MNT-billable condition

Question 11

Nutrition assessment includes:

Answer 11

• food and nutrition-related history
• biochemical data, medical tests and procedures
• anthropometric measures
• NFPE (nutrition focused physical findings)
• relevant client history

Question 12

During assessment, RDN:

Answer 12

collects data and information to compare against standards

Question 13

During diagnoses, RDN:

Answer 13

identify and label actual problem of the pt/client

Question 14

Screening determines:
Assessment determines:

Answer 14

• risk of a problem
• presence of a problem

Question 15

?: clearly defined and measurable markers to be used as signs and symptoms in Nutrition Diagnoses and markers of progression during Nutrition M&E

Answer 15

Nutrition Care indicators

Question 16

Nutrition care indicators are compared to:

Answer 16

Nutrition care criteria

Question 17

Nutrition assessment in nutrition education:

Answer 17

ask client about nutrition concerns/fill out questionnaire/pre-test

Question 18

Nutrition assessment in MNT:

Answer 18

use of MNT Evidence-Based guide for practice to collect relevant data

Question 19

Food and Nutrition Related history:

Answer 19

Intake, medications, CAM (complementary and alternative medicine), knowledge/beliefs, availability of foods, physical activity, nutrition related quality of life.

Question 20

Intake via:

Answer 20

24 hour recalls, food frequency questionnaires, food records

Question 21

Medications Interactions can:

Answer 21

• decrease appetite
• decrease intake due to N/V, mouth sores
• decrease nutrient absorption (laxatives, anticonvulsants)
• decrease nutrient production
• interfere nutrient metabolism

Question 22

CDC recommends WHO charts used for children between the ages:

Answer 22

0-2 years

Question 23

CDC recommends CDC charts used for children aged:

Answer 23

over age of 2 yrs

Question 24

WHO 0-2 years (0-24 months) includes:

Answer 24

length-for-age
wt-for-age
head circumference-for-age
wt-for-lenght

Question 25

WHO 0-3 years (0-36 months) includes:

Answer 25

length-for-age wt-for-age head cicumference-for-age wt-for-length

Question 26

CDC 2-5 yrs includes:

Answer 26

wt-for-stature

Question 27

CDC 2-20 yrs includes:

Answer 27

wt-for-age stature-for-age BMI-for-age

Question 28

which growth charts are used for nutritional risk screening:

Answer 28

wt-for-length wt-for-stature BMI-for-age

Question 29

Z scores Mild malnutrition

Answer 29

-1 to -1.9

Question 30

Z scores moderate malnutrition

Answer 30

-2 to -2.9

Question 31

Z scores severe malnutrition

Answer 31

>/= -3

Question 32

Short stature

Answer 32

WHO (0-2 yrs): length-for-age <2nd percentile CDC (+2yrs): ht-for-age <3rd or <5th percentile

Question 33

Underwt

Answer 33

WHO (0-2yrs): wt-for-length <2nd percentile CDC (+2yrs): BMI-for-age <3rd or <5th percentile

Question 34

Overwt

Answer 34

WHO (0-2 yrs) wt-for-length >98th percentile CDC (+2yrs): overwt= BMI-for-age 85th-95th percentile obese= BMI-for-age >95th percentile

Question 35

Ht measured:

Answer 35

directly: stadiometer indirectly: knee-ht measurements, arm spans, recumbent length

Question 36

Wt measured:

Answer 36

IBW using Hamwi Usual body wt (pt reported) Current body wt (measured) Adjusted body wt

Question 37

ABW

Answer 37

ABW (kg)= [(CBW-IBW) x 0.25] + IBW

Question 38

IBW (Hamwi men and women)

Answer 38

Men: 106 lbs + (6lbs per inch over 5 feet) Women: 100 lbs + (5lbs per inch over 5 feet)

Question 39

Amputations

Answer 39

- Arm= 5% - Forearm + Hand= 2.3% - Hand= 0.7% - Leg= 16% - Lower leg + Foot= 5.9% - Foot= 1.5%

Question 40

BMI

Answer 40

= wt(kg)/ ht (m)^2

Question 41

Kilograms to pounds= Pounds to Kilograms=

Answer 41

x 2.2 / 2.2

Question 42

Convert Inches to meters=

Answer 42

divide inches by 39.37

Question 43

Category and BMI

Answer 43

underwt= <18.5 normal wt= 18.5-24.9 overwt= 25-29.5 obese= >/= 30 class 1= 30-34.9 class 2= 35-39.9 class 3= >/= 40

Question 44

Percent wt change=

Answer 44

(previous wt-current wt)/previous wt X100 OR wt loss/previous wt x 100

Question 45

Degree of wt loss and time frame (SIGNIFICANT)

Answer 45

1 week= 1-2% 1 month= 5% 3 months= 7.5% 6 months= 10%

Question 46

Degree of wt loss and time frame (SEVERE)

Answer 46

1 week= >1.2% 1 months= >5% 3 months= >7.5% 6 months= >10%

Question 47

Body composition measures:

Answer 47

fat mass to fat-free mass

Question 48

Direct methods for body compositions include:

Answer 48

- BOD-POD: air displacements rather than body water content - Bioelectrical impedance analysis: lean body tissue has higher electrical conductivity and lower impedance than fatty tissue (dependent on water, so must hydrate no caffeine or diuretics) - DEXA: measures bone, fat, muscle compartments using xrays - Underwater weighing: uses water displacement to estimate body volume

Question 49

Indirect methods for body composition:

Answer 49

skin folds, midarm muscle circumference, midarm circumference

Question 50

Nitrogen Balance=

Answer 50

1) 24hr urinary urea nitrogen= (protein g 24 hrs/6.25 g) - (urinary urea nitrogen + 4) 2) 24hr total urinary nitrogen= (protein g 24hrs/6.25g) - (total urea nitrogen + 2)

Question 51

NFPE

Answer 51

overall appearance, hair, face, eyes, mouth, nails, legs/feet, neurological, skin

Question 52

Hair thin, sparse, dull, dry brittle OR easily pluckable

Answer 52

vit C and protein deficiency OR: protein deficiency

Question 53

eyes pale, dry, poor vision

Answer 53

vit A, zinc, riboflavin deficiency

Question 54

Lips swollen, red, dry, cracked

Answer 54

riboflavin, pyridoxine, niacin def

Question 55

Gums sore, red, swollen, bleeding

Answer 55

Vit C def

Question 56

Teeth missing, loose, loss of enamel

Answer 56

Calcium def, poor intake

Question 57

Skin pale, dry, scaly

Answer 57

iron, folic acid, zinc def

Question 58

Nails brittle, thin, spoon-shaped

Answer 58

iron or protein def

Question 59

Auscultation

Answer 59

listening to bowel using stethoscope on RLG (ileocecal valve) - NORM: gurgling high pitched every 5-15 sec - HYPOACTIVE: sounds every 15-20 sec (could indicate paralytic ileus or peritonitis) - HYPERACTIVE: continuous high pitched, diarrhea/intestinal obstructoin

Question 60

Food security:

Answer 60

Access by all people at all times, no food access problems or limitations

Question 61

Marginal food security:

Answer 61

some anxiety over food sufficiency or shortage in household, little or no indication of diet change or reduced food intake

Question 62

Low food security:

Answer 62

food quality, variety, diet desirability of household members reduced because household lacks money, little to no indication of reduced intake

Question 63

Very low food security:

Answer 63

food intake of household reduced and normal eating patterns are disrupted multiple times