CSSD Nutrition Assessment & Counseling Strategies 5 — Questions and Answers
Question 1: A sports dietitian uses motivational interviewing with an athlete who says, 'I know I should eat breakfast before practice, but I'm never hungry in the morning.' Which response best demonstrates a complex reflection?
- 'You understand breakfast matters for performance, yet your body's signals make it feel unnecessary early in the day.' (Correct answer)
- 'You should try eating a small snack at least.'
- 'Have you tried setting an alarm 30 minutes earlier to build appetite?'
- 'Many athletes feel the same way — it's a common barrier.'
Correct answer: 'You understand breakfast matters for performance, yet your body's signals make it feel unnecessary early in the day.'
A complex reflection paraphrases both the stated content and the implied emotion or meaning, going beyond simply repeating what was said.
Question 2: When interpreting a dietary recall from an athlete who is vegetarian, which nutrient requires the MOST careful assessment for adequacy?
- Vitamin B12 (Correct answer)
- Vitamin C
- Folate
- Potassium
Correct answer: Vitamin B12
Vitamin B12 is found almost exclusively in animal products, making it the primary nutrient of concern for athletes following vegetarian or vegan diets.
Question 3: In the Nutrition Care Process (NCP), which step immediately follows the Nutrition Diagnosis?
- Nutrition Intervention (Correct answer)
- Nutrition Assessment
- Nutrition Monitoring and Evaluation
- Nutrition Screening
Correct answer: Nutrition Intervention
The NCP follows four steps in order: Assessment → Diagnosis → Intervention → Monitoring and Evaluation.
Question 4: A track athlete reports unintentional weight loss of 4 kg over 6 weeks. After reviewing intake and expenditure, the dietitian identifies an energy deficit of approximately 600 kcal/day. Which physical assessment finding would MOST support this energy deficit estimate?
- Loss of approximately 3.5 kg of fat mass confirmed by DXA (Correct answer)
- Increased muscle hypertrophy on skinfold assessment
- Elevated serum albumin
- Increased resting heart rate within normal limits
Correct answer: Loss of approximately 3.5 kg of fat mass confirmed by DXA
A 600 kcal/day deficit over 42 days equals ~25,200 kcal, roughly equivalent to ~3.4 kg of fat (9,500 kcal/kg fat tissue), supporting the DXA finding.
Question 5: Which PES (Problem, Etiology, Signs & Symptoms) statement correctly formats a nutrition diagnosis for an athlete with low energy availability?
- Inadequate energy intake (NI-1.4) related to intentional restriction of caloric intake as evidenced by EA of 22 kcal/kg FFM/day and weight loss of 3 kg in 4 weeks (Correct answer)
- Low energy availability related to female athlete triad evidenced by amenorrhea
- Weight loss related to poor diet quality as evidenced by low calorie intake
- Malnutrition related to sport training evidenced by fatigue
Correct answer: Inadequate energy intake (NI-1.4) related to intentional restriction of caloric intake as evidenced by EA of 22 kcal/kg FFM/day and weight loss of 3 kg in 4 weeks
A properly formatted PES statement uses an Academy-approved diagnostic term, a specific etiology, and measurable signs and symptoms.
Question 6: A combat sport athlete wants to lose 5 kg in 2 weeks before a weigh-in. The dietitian's MOST appropriate response is to:
- Educate the athlete on the performance and health risks of rapid weight cutting and discuss gradual pre-season weight management (Correct answer)
- Prescribe a severe caloric restriction diet to achieve the 5 kg goal safely
- Help the athlete use fluid restriction and saunas to achieve the weight cut efficiently
- Decline to provide any guidance and refer to the team physician only
Correct answer: Educate the athlete on the performance and health risks of rapid weight cutting and discuss gradual pre-season weight management
The CSSD's ethical role includes educating athletes about the dangers of acute weight cutting while supporting safer long-term weight management strategies.
Question 7: Which method is considered the criterion standard for measuring body composition in clinical and research settings, providing separate values for bone, fat, and lean mass?
- Dual-energy X-ray absorptiometry (DXA) (Correct answer)
- Hydrostatic weighing
- Air displacement plethysmography (ADP)
- Skinfold anthropometry
Correct answer: Dual-energy X-ray absorptiometry (DXA)
DXA uses two X-ray energies to differentiate bone mineral, fat mass, and lean soft tissue in a three-compartment model, making it the clinical gold standard.
CSSD Nutrition Assessment & Counseling Strategies 5
A sports dietitian uses motivational interviewing with an athlete who says, 'I know I should eat breakfast before practice, but I'm never hungry in the morning.' Which response best demonstrates a complex reflection?