CSA CSA Dietary & Nutrition Services 2 — Questions and Answers
Question 1: Which score on the Mini Nutritional Assessment (MNA) indicates that a nursing facility resident is at risk for malnutrition and requires a full dietitian assessment?
- 24–30
- 17–23.5 (Correct answer)
- Less than 17
- Any score below 30
Correct answer: 17–23.5
An MNA screening score of 17–23.5 indicates risk for malnutrition and should trigger a full dietitian assessment and care plan intervention.
Question 2: Federal regulations require that a nursing facility provide each resident with adequate fluid intake. What is the generally recommended minimum daily fluid intake for nursing facility residents?
- 500–750 mL/day
- 1,000–1,200 mL/day
- 1,500–2,000 mL/day (Correct answer)
- 3,000–3,500 mL/day
Correct answer: 1,500–2,000 mL/day
Most clinical guidelines and CMS surveyors expect long-term care residents to receive at least 1,500–2,000 mL of fluid daily to prevent dehydration.
Question 3: A nursing facility kitchen must maintain food at safe holding temperatures according to food safety principles. What is the minimum internal hot-holding temperature for cooked foods?
- 100°F (38°C)
- 135°F (57°C) (Correct answer)
- 165°F (74°C)
- 180°F (82°C)
Correct answer: 135°F (57°C)
According to FDA Food Code guidelines adopted by most states, hot foods must be held at or above 135°F (57°C) to prevent bacterial growth.
Question 4: CMS requires that a nursing facility have a qualified dietitian on staff or on contract. What credential designates a 'qualified dietitian' under federal regulations?
- Certified Dietary Manager (CDM)
- Registered Dietitian Nutritionist (RDN) (Correct answer)
- Licensed Food Service Supervisor (LFSS)
- Certified Nutrition Support Clinician (CNSC)
Correct answer: Registered Dietitian Nutritionist (RDN)
Federal regulations specify that a 'qualified dietitian' means a Registered Dietitian Nutritionist (RDN) credentialed by the Commission on Dietetic Registration.
Question 5: A nursing facility resident refuses to eat and is losing significant weight. Which of the following is the FIRST appropriate action by the administrator?
- Immediately initiate tube feeding without a physician order
- Ensure the IDT evaluates the resident and updates the care plan to address nutritional decline (Correct answer)
- Discharge the resident to a hospital
- Document the refusal and take no further action
Correct answer: Ensure the IDT evaluates the resident and updates the care plan to address nutritional decline
Significant unintended weight loss requires an immediate interdisciplinary team response to investigate causes and update the care plan with targeted interventions.
Question 6: Under 42 CFR §483.60, how many meals per day must a nursing facility provide, and what is the maximum time allowed between the evening meal and breakfast?
- 2 meals; 10-hour gap maximum
- 3 meals; 14-hour gap maximum (Correct answer)
- 3 meals; 16-hour gap maximum
- 4 meals; 12-hour gap maximum
Correct answer: 3 meals; 14-hour gap maximum
Federal regulations require at least 3 meals per day with no more than 14 hours between the evening meal and breakfast, unless a late evening snack is offered.
CSA CSA Dietary & Nutrition Services 2
Which score on the Mini Nutritional Assessment (MNA) indicates that a nursing facility resident is at risk for malnutrition and requires a full dietitian assessment?