DIET AND DISEASE

Belmont Sport Science

TEST 2
N. HUNT
SPRING 2016 NAME

1. Type II diabetes is characterized by all of the following EXCEPT:

A. obesity
B. slow progression of the disease process
C. a problem with insulin secretion
D. cells that become insensitive to insulin

2. All of the following are symptoms of diabetes EXCEPT:

A. glucosuria
B. hyperthyroidism
C. hyperglycemia
D. dehydration

3. An example of an short acting insulin or the type used in a sliding scale is:
A. regular
B. ultralente
C. lantus
D. NPH

4. The onset of Type I is characterized by all of the following EXCEPT:

A. weight loss
B. ketosis
C. insensitivity to insulin
D. rapid onset

5. All of the following are complications of diabetes EXCEPT:

A. nephropathy
B. atherosclerosis
C. neuropathy
D. gastric ulcers
E. retinopathy

6. The appropriate diabetic diet for an individual with Type I includes all EXCEPT:
A. low glycemic index foods
B. emphasis on complex carbohydrates
C. low carbohydrate diet
D. limited sugar

7. Carbohydrates in a diabetic diet for a Type I client are:

A. divided fairly evenly into meals and snacks
B. provided in only 3 meals per day
C. coordinated with the insulin schedule
D. A and C
8. The most common lipid elevated in the blood of someone with diabetes is:
A. total cholesterol
B. HDL
C. LDL
D. Triglycerides

9. All of the following are goals of therapy for diabetics EXCEPT:

A. maintain blood glucose levels in an acceptable range
B. prevent or delay complications
C. encourage a sedentary lifestyle
D. minimize changes in blood glucose levels

10. Components that must be coordinated in the treatment of Type I include all of the following EXCEPT:
A. sleep
B. insulin
C. diet
D. exercise

11. Type II diabetics should consume a minimum of meals per day.

A. 2 C. 4
B. 3 D. 5

12. Symptoms of hyperglycemia can be precipitated by all of the following EXCEPT:

A. illness
B. too little insulin
C. too little food
D. large amounts of concentrated sweets

13. The major cause of death for someone with diabetes is:
A. infections
B. atherosclerosis
C. gangrene
D. neuropathy

14. Diabetic diets high in have been shown to help control blood glucose by enabling the body to
handle glucose more efficiently.
A. fiber
B. zinc
C. Vitamin A
D. protein

15. Calories from fat in the diabetic diet should be:

A. equally divided between saturated and polyunsaturated fats
B. derived mainly from unsaturated fats
C. derived mainly from saturated fats
D. equally divided between monounsaturated and saturated fats.

Identify the dietary approaches on the left which are appropriate for the types of diabetes listed on the right.
 A 16. eat regular snacks A. Type I diabetes
B. Type II diabetes
B 17. reduction in calories

A 18. meals consumed at regular times

A 19. eat extra food for intense exercise

A 20. consistent ratio of carbohydrate at each feeding

Identify whether the symptoms listed on the left are characteristic of hypoglycemia or hyperglycemia, as
indicated on the right.

B 21. glucosuria A. hypoglycemia

B. hyperglycemia
A 22. irritability

A 23. headache

B 24. intense thirst

25. A normal fasting blood glucose level is:

A. 50-160 mg/dl
B. 50-100 mg/dl
C. 70-99 mg/dl
D. 70-180 mg/dl

26. A lab test which indicates average blood sugar control over a 2-4 month time period is:
A. glucose tolerance test
B. glycolated hemoglobin (hgb A1c)
C. fasting blood sugar test
D. urine testing

27. Individuals with Type I need insulin because they:

A. have become insulin resistant.
B. have developed hyperinsulinemia.
C. no longer synthesize insulin.
D. digest insulin with GI enzymes.

28. Which of the following best describes clients with Type II?
A. usually lean
B. rapid onset of symptoms
C. weight loss needed
D. ketosis resistant
E. both C and D

For question 29:

Mrs. Barclay's physician has prescribed 7U Reg and 15U NPH for control of her diabetes. Mrs. Barclay is
5'3", weighs 112 lbs., and is an active woman who plays handball three times per week.
29. While preparing her for discharge, the nurse should tell Mrs. Barclay that:
A. she does not need to eat extra food for exercise.
B. she should eat three meals only to cover the action of her insulin.
C. time of meals is not important.
D. if she drinks alcoholic beverages, she is at risk of hypoglycemia.

30. When NPH insulin is administered once daily, before breakfast, hypoglycemic reactions are most likely
to occur:
A. 2 hours after the drug is injected.
B. at midday (before lunch).
C. In the afternoon before the third meal of the day (supper).
D. at bedtime.

31. Which of the following represents an appropriate snack at the beginning of an episode of
hypoglycemia?
A. potato chips
B. 1/2 cup orange juice
C. 10 saltine crackers
D. 1 piece of chewing gum

For question 32:

Hector Martinez is a 70 year old Hispanic man recently diagnosed with Type II. He is having difficulty
understanding the exchange system and has limited financial resources.
32. Which of the following strategies is most likely to help him control his diabetes?
A. Emphasize how important it is to follow only the exchange system.
B. Try simplified diet approach such as the plate method.
C. Give him a printed exchange list of traditional Hispanic foods.
D. Encourage him to join a spa and exercise.

For question 33:

Mr. Merwin is a 45 year old man with Type II. He is 5'9" tall and weights 210 lbs. His diabetes is
currently controlled with diet alone.
33. The following would be recommendations for him except:
A. eat more fish and poultry.
B. increase physical activity.
C. eat most of his fat from unsaturated sources.
D. eat less starches.

34. Evaluate the following two statements:

1. Physiological stress, such as surgery, causes an increase in blood glucose.
2. Clients with type II diabetes may benefit from oral medications.

A. 1 is true, 2 is false
B. 1 is false, 2 is true
C. both 1 and 2 are true
D. both 1 and 2 are false

For question 35:

Mrs. Filbert, age 56, has been diagnosed with Type I. During discharge instructions she makes a number
of statements.
35. Which one indicates some understanding of her diabetes management?
A. "If my blood glucose is between 100-150 mg/dl, I should not exercise."
B. "If I eat high fat foods, my blood sugars will be elevated."
C. "Adding cheese or peanut butter to my bedtime snack may prevent hypoglycemia during the
night."
D. "Red beans can be exchanged for broccoli on my diet."

For question 36:

Jane Smith is a 36 year old client with Type I who has experienced frequent episodes of hypoglycemia.
36. The most helpful tool for evaluating what is causing the hypoglycemia is?
A. glycosylated hemoglobin level.
B. blood glucose monitoring records.
C. triglyceride levels.
D. fasting blood sugar levels.

37. Type 2 diabetics can be given on oral medication to help control their blood sugar.
A. True B. False

For question 38:

A 50 year old woman with uncontrolled Type II is admitted to the hospital for the initiation of insulin
therapy. She received 25U of NPH insulin at 8:00 am. At 4:00 pm she is complaining of rapid heart rate
and shakiness.
38. The first thing the nurse should do is:
A. give her 1/2 c. orange juice.
B. call the physician.
C. give her skim milk and two crackers.
D. check her blood sugar.

39. Which of the following receives a high priority in the treatment of Type II because of its beneficial
effects in reversing insulin resistance, improving blood lipids and reducing blood pressure?
A. physical activity
B. a low-fat diet
C. weight loss
D. a sodium-restricted diet
E. all the above

40. Type II diabetics are high risk for ketoacidosis.

A. True B. False

41. Symptoms of cirrhosis include all of the following except:

A. esophageal varices C. ascites
B. obesity D. disorientation

42. In hepatic coma, diets high in branched-chain amino acids are indicated.
A. True B. False

43. Dietary management of cirrhosis may include all of the following except:
A. protein restriction
B. calorie restriction
C. vitamin and mineral supplement
D. sodium restriction

44. Portal vein hypertension is caused by obstructed blood flow through the liver.
A. True B. False
45. The most common cause of cirrhosis in the U.S. is:
A. the use of drugs C. malnutrition
B. obesity D. chronic alcohol abuse

46. Fatty liver occurs when _____ accumulate in the liver.

A. bile salts C. triglycerides
B. alcohol waste products D. proteins

47. The term used to describe an inflammation of liver tissue is:

A. cirrhosis C. cholecystitis
B. pancreatitis D. hepatitis

48. When signs and symptoms of hepatic encephalopathy appear you should anticipate:
A. an increase in dietary protein.
B. a restriction of protein intake.
C. the use of agents to slow peristalsis.
D. a reduction of dietary branch chain amino acids.

49. A physical sign of altered liver function is:

A. ascites
B. edema
C. jaundice
D. all of the above

50. For a diabetic diet, a croissant containing 15 grams of carbohydrate and 30 grams of fat
should be counted as:
A. 1 bread and 4 fats
B. 1 fruit and 6 fats
C. 1 bread and 6 fats
D. 1 fruit and 4 fats

51. Which of the following foods is not found in the vegetable exchange group?
A. potatoes D. tomatoes
B. green beans E. all are in the vegetable group
C. broccoli

52. A person with pancreatitis may experience steatorrhea.

A. True B. False

53. Which of the following groups of foods are most appropriate for a Type II diabetic:
A. turkey breast, mashed potatoes with gravy, green beans and coconut pie
B. scrambled eggs, toast with jelly, orange juice, and whole milk
C. beef tenderloin, wild rice, green beans, and skim milk
D. cheeseburger with lettuce and tomato, apple, and chocolate milkshake

54. How many choices from the carbohydrate counting list is in C above assuming the rice is 1 cup and the
milk is 1 cup?
A. 1
B. 2
 C. 3
D. 4

55. How many exchanges are in the following dinner: 3ozs. baked chicken, ½ cup mashed potatoes, 1
apple, 1 tsp. margarine, 1 roll?
A. 1 meat, 1 starch, 2 fruits, 1 fat
B. 1 meat, 1 starch, 1 fruits, 1 fat
C. 3 meat, 2 starch, 1 fruit, 1 fat
D. 3 meat, 1 starch, 2 fruits, 1 fat

56. Which of the following receives a high priority in the treatment of Type II because of its beneficial
effects in reversing insulin resistance, improving blood lipids and reducing blood pressure?
A. snacks between meals
B. a low-fat diet
C. weight loss
D. a sodium-restricted diet

57. A person with liver disease that involves ascites is usually on a ___________ restricted diet.
A. sodium
B. fluid
C. fat
D. both A and B
E. all of the above

58. A type 1 diabetic has a hemoglobin A1c of 9.0%. The client should:
A. continue her current level of diabetes management
B. decrease her carbohydrate intake to prevent hyperglycemia
C. be assessed to determine where changes are needed in insulin, diet, and/or exercise patterns
D. begin a daily, intensive exercise regimen

59. A 25-year old man with Type 1 diabetes eats 2 meals a day between 9 a.m. and 5p.m. (he skips lunch).
He takes regular and NPH insulin twice daily at 7 a.m. and 4 p.m. Which best indicates how he will feel?
A. hyperglycemic before 9 a.m. and hypoglycemic after 7 p.m.
B. hypoglycemic before 9 a.m. and hyperglycemic after 7 p.m.
C. hyperglycemic before 9 a.m. and hyperglycemic in mid-afternoon
D. hypoglycemic before 9 a.m. and hypoglycemic in mid-afternoon

60. The dietitian has been consulted to instruct a newly diagnosed Type 1 diabetes patient.
During the nutrition assessment, the RD discovers that the patient cannot read. What should the RD focus
on?
A. demonstrating the exchange lists through pictures
B. avoidance of simple CHO
C. consistency in day-to-day meal CHO content
D. reviewing the exchange lists slowly

61. From the list of foods that follow, determine the number of starch exchanges: 1 slice bread, ½ cup
potatoes, ½ cup cooked carrots, and 1 cup skim milk
A. 3
B. 2
C. 5
D. 4
62. A patient is being seen at an outpatient clinic for diabetes management. His insulin regimen has
recently been adjusted, due to a medical diagnosis related to the dawn phenomenon. Which of the following
describes the dawn phenomenon?
A. late evening hypoglycemia
B. late evening hyperglycemia
C. early morning hypoglycemia
D. early morning hyperglycemia

63. A person diagnosed with hypoglycemia would need to follow which of the following:
A. eat frequently, include sugar at each meal
B. eat frequently, include protein at each meal
C. eat only 3 meals per day, avoid sugar
D. eat only 3 meals per day, include protein at each meal

64. Gestational diabetes refers to:

A. a person with diabetes who becomes pregnant
B. a person who develops diabetes during the pregnancy
C. a person who is obese when they become pregnant
D. a person who develops diabetes after the pregnancy

65. A patient has the following symptoms: severe abdominal pain, nausea, vomiting, and
elevated lipase and amylase. What is the most likely diagnosis?
A. Irritable bowel syndrome
B. Diverticulosis.
C. Acute pancreatitis
D. None of the above

66. What is the most frequent cause of chronic pancreatitis?

A. Alcohol abuse
B. Cystic fibrosis
C. Virus
D. Acute pancreatitis

67. A genetic disorder that causes the over production of mucus that affects digestive function
is:
A. Pancreatitis.
B. Crohn’s disease
C. Celiac disease
D. Cystic fibrosis

68. The most appropriate diet restriction for someone with ball bladder disease is:
A. High fiber C. Low sodium
B. Low fat D. Fluid restricted