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A resident is admitted to a long-term care facility. The initial nutrition assessment is completed on day 8 and is charted in the progress note section of the medical record. A week later, an error is noticed in the nutrition assessment, involving the height and weight of the resident. Correction fluid (White Out) is used to correct the error, and a follow-up note is placed in the chart. What is wrong in this situation?
❎ The accuracy of height and weight is not important
❎ The nutrition assessment should be placed in the dietary section
⭕️ Correction fluid (White Out) should never be used in a medical record
❎ The nutrition assessment should be documented on day 14
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A diet history is needed for a client who is admitted to a nursing home. Generally accepted methods for obtaining this information include all of the following EXCEPT a:
❎ Food frequency questionnaire
⭕️ 7-day food diary
❎ 3-day food record
❎ 24-hour recall
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The main purpose of nutrition screening is to identify individuals who may:
⭕️ Be at risk for malnutrition
❎ Need to lose weight
❎ Not be getting enough calcium
❎ Not be drinking enough fluids
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Which of the following laboratory values indicates dehydration?
⭕️ Serum sodium of 155 mEq/L
❎ Serum sodium of 130 mEq/L
❎ Serum albumin of 3.6 g/dL
❎ Serum potassium of 4 mEq/L
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The physician has ordered a low-fiber diet for a resident who is experiencing a flare-up of diverticulitis. How would the following breakfast menu be modified to meet the changes ordered by the physician?
• ½ cup all-bran cereal
• 1 toasted English muffin
• 1 banana
• ½ cup orange juice
• ½ cup low-fat milk
• 1 cup of coffee
❎ Change the banana to prunes
❎ Eliminate the orange juice
⭕️ Change the cereal to corn flakes
❎ Eliminate the English muffin
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A resident who is Muslim is admitted to a health care facility. The physician orders a diet consisting of mechanical soft, high protein and no concentrated sweets. Which of the following lunch menus is most appropriate for this resident?
❎ Spaghetti and meatballs, salad with ranch dressing, bread, butter, and ginger ale
⭕️ Meatloaf made from ground beef, mashed potatoes, steamed carrots, unsweetened canned pears, and low-fat milk
❎ Tuna sandwich, tapioca pudding, and apple juice
❎ Hotdog, potato chips, fresh fruit cup, and low-fat milk
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Mary has been a resident at a long-term care facility for 3 months. She is on a regular diet, has no acute nutritional issues, is able to feed herself, and is maintaining her admission weight.
When does Mary require her nutritional care plan to be reviewed and updated?
⭕️ Quarterly
❎ Every 6 months
❎ Every month
❎ Every week
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Mary has been a resident at a long-term care facility for 3 months. She is on a regular diet, has no acute nutritional issues, is able to feed herself, and is maintaining her admission weight.
The dietary manager has completed the review of Mary’s care plan. Two weeks later, Mary refuses meals complaining of having no appetite. The nursing staff reports that she is losing weight. The dietary manager should next do which of the following?
⭕️ Immediately update Mary’s nutrition care plan with an intervention to address her lack of appetite and weight loss
❎ Ask the nurses to let the dietary manager know if the situation does not improve within 2 weeks
❎ Wait until the next quarterly evaluation to intervene
❎ Ask the physician for an order for nutritional supplements to be sent to the resident twice a day
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In an assisted living facility with 75 beds, the dietary manager is mostly likely to choose which of the following menus for a varied population with many different diet restrictions?
❎ Nonselective menu
⭕️ Semiselective menu
❎ Selective menu
❎ Static menu
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A patient’s wife has requested information from the dietary manager, regarding a heart healthy diet to lower cholesterol for her own information. What would be the most appropriate materials to provide to the patient?
⭕️ Provide some simple materials that concern fat in the diet from the American Heart Association and the name of a dietitian
❎ Provide the woman with information on reducing sodium in her diet
❎ Tell the woman her request cannot be accommodated without an order from her physician
❎ Find any web site on the Internet that has information that can be printed
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A 70-year-old patient has been admitted for short-term rehab as a result of a fractured hip. He has a history of type 2 diabetes that is controlled with medication. After interviewing this patient, it appears that he has not been following any special diet because he feels that the medication should be taking care of the blood sugar. The dietary manager is asked to begin to educate him on the appropriate diet. What are ways in which to evaluate the progress of this patient while he is a patient in the rehab facility?
❎ Set goals for the patient, and then check with him the week that he is scheduled for discharge to assess progress
❎ Provide the patient with a follow-up quiz that he can complete at his leisure since he will be staying for a few weeks
⭕️ Provide the patient with a regular selective menu, and review his menu choices daily, making corrections as needed to meet his dietary requirements
❎ Ask the patient yes and no questions every week to see if he can answer correctly
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Many of the residents of a nursing home require minced or pureed meals because they have chewing and swallowing issues. What factors should be taken into account when planning meals?
⭕️ The Food Guide Pyramid should be followed as closely as possible with care taken to present the food as attractively as possible
❎ The food items on the regular diet can be pureed and served as most of these residents will not know the difference anyway due to dementia or inability to communicate effectively
❎ All foods can be prepurchased as baby food, according to the specific texture ordered
❎ The standard menu selections should be put in the blender and pureed and then served to residents with a diet order of puree/minced
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Oral nutritional supplements are appropriate in a patient who is:
❎ Having difficulty swallowing
⭕️ Experiencing a 6% weight loss
❎ Requesting “milkshakes”
❎ On a “no concentrated sweets” diet
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A number of complaints have been received about the meals in a health care facility. Options for continuous quality improvement to address this issue include all of the following EXCEPT:
❎ Test trays
❎ Patient surveys
❎ Plate waste studies
⭕️ Employee surveys
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All of the following is information that may be obtained in a patient satisfaction survey EXCEPT:
❎ Opinions on the temperature of the food and timing of meals
❎ Perceptions on the service received from the food service employees
⭕️ Opinions on the cost of meals and suggestions for improvements
❎ Opinions on the menu selections and tray accuracy
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