ISSA Nutrition Assessment & Client Evaluation 2 — Questions and Answers
Question 1: A client's 3-day food diary shows consistently low iron intake. Which follow-up assessment tool would BEST confirm iron-deficiency risk before making dietary recommendations?
- 24-hour dietary recall
- Serum ferritin lab test (Correct answer)
- Food frequency questionnaire
- Skinfold caliper measurement
Correct answer: Serum ferritin lab test
Serum ferritin is the most sensitive biomarker for iron stores and confirms deficiency risk that dietary intake logs only suggest.
Question 2: When calculating a client's estimated energy requirement using the Mifflin-St Jeor equation, which variable is NOT directly used in the formula?
- Body weight
- Height
- Age
- Waist circumference (Correct answer)
Correct answer: Waist circumference
Mifflin-St Jeor uses weight, height, age, and sex to estimate RMR; waist circumference is a body composition measure, not part of the equation.
Question 3: A nutritionist notices a client's food diary includes frequent fast food meals but the client denies eating out often during the interview. This discrepancy is BEST addressed by:
- Discarding the food diary data
- Confronting the client about dishonesty
- Exploring barriers to home cooking non-judgmentally (Correct answer)
- Repeating the 24-hour recall only
Correct answer: Exploring barriers to home cooking non-judgmentally
Non-judgmental exploration of lifestyle barriers builds rapport and uncovers the true factors driving the client's eating patterns.
Question 4: Which anthropometric measurement is MOST useful for estimating visceral adiposity and associated metabolic risk in a male client?
- Hip circumference
- Waist circumference (Correct answer)
- Mid-arm circumference
- Skinfold thickness at the tricep
Correct answer: Waist circumference
Waist circumference is the primary anthropometric proxy for visceral fat and cardiometabolic risk according to major health guidelines.
Question 5: A client presents with a BMI of 17.2. According to WHO classification, this places the client in which category?
- Normal weight
- Overweight
- Mild thinness
- Moderate thinness (Correct answer)
Correct answer: Moderate thinness
WHO classifies BMI 16.0–16.9 as moderate thinness and 17.0–18.49 as mild thinness; 17.2 falls in the mild thinness range.
Question 6: During a nutrition intake interview, using open-ended questions primarily helps the nutritionist to:
- Collect precise caloric data faster
- Encourage the client to elaborate and share context (Correct answer)
- Reduce the length of the consultation
- Confirm the client's medical diagnoses
Correct answer: Encourage the client to elaborate and share context
Open-ended questions invite narrative responses that reveal eating habits, motivations, and barriers not captured by yes/no formats.
Question 7: A registered dietitian uses the NCI Diet History Questionnaire (DHQ) in research. This instrument is classified as a:
- 24-hour dietary recall
- Food frequency questionnaire (Correct answer)
- Weighed food record
- Food propensity questionnaire
Correct answer: Food frequency questionnaire
The DHQ is a self-administered food frequency questionnaire designed to estimate usual dietary intake over the past year.
ISSA Nutrition Assessment & Client Evaluation 2
A client's 3-day food diary shows consistently low iron intake.
Which follow-up assessment tool would BEST confirm iron-deficiency risk before making dietary recommendations?