ISSA Nutrition Assessment & Client Evaluation 3 — Questions and Answers
Question 1: When using the dual-energy X-ray absorptiometry (DEXA) scan as a reference method for body composition, which compartment model does it primarily measure?
- Two-compartment model (fat mass + fat-free mass)
- Three-compartment model (fat, bone, soft tissue) (Correct answer)
- Four-compartment model
- Five-compartment model
Correct answer: Three-compartment model (fat, bone, soft tissue)
DEXA partitions body mass into fat mass, bone mineral content, and lean soft tissue, making it a three-compartment model.
Question 2: A client reports feeling fatigued and experiencing cold intolerance. As part of a comprehensive nutrition assessment, the MOST relevant biochemical marker to request would be:
- Serum cholesterol
- Thyroid-stimulating hormone (TSH) (Correct answer)
- Blood urea nitrogen (BUN)
- Serum sodium
Correct answer: Thyroid-stimulating hormone (TSH)
Fatigue and cold intolerance are hallmark symptoms of hypothyroidism; TSH is the primary screening test for thyroid dysfunction.
Question 3: Which of the following BEST describes the purpose of a nutrition-focused physical exam (NFPE)?
- To diagnose underlying diseases
- To identify clinical signs and symptoms of malnutrition or nutrient deficiencies (Correct answer)
- To measure body composition via skinfolds
- To calculate dietary reference intakes
Correct answer: To identify clinical signs and symptoms of malnutrition or nutrient deficiencies
NFPE uses observable physical signs—such as hair loss, skin changes, or muscle wasting—to detect possible malnutrition and micronutrient deficiencies.
Question 4: A sports nutrition client has a resting metabolic rate (RMR) of 1,800 kcal/day and trains for 2 hours daily at a moderate intensity. Using an activity factor of 1.6, what is the estimated total daily energy expenditure (TDEE)?
- 2,160 kcal
- 2,880 kcal (Correct answer)
- 3,240 kcal
- 1,980 kcal
Correct answer: 2,880 kcal
TDEE = RMR × activity factor = 1,800 × 1.6 = 2,880 kcal/day.
Question 5: In a dietary assessment, systematic underreporting of food intake is MOST commonly associated with which client population?
- Children under age 10
- Older adults with dementia
- Individuals with overweight or obesity (Correct answer)
- Athletes in training
Correct answer: Individuals with overweight or obesity
Research consistently shows that individuals with overweight or obesity underreport energy intake by a greater margin than normal-weight individuals, often due to social desirability bias.
Question 6: The Nutrition Care Process (NCP) step that immediately follows nutrition assessment is:
- Nutrition monitoring and evaluation
- Nutrition diagnosis (Correct answer)
- Nutrition intervention
- Nutrition counseling
Correct answer: Nutrition diagnosis
The NCP sequence is: Assessment → Diagnosis → Intervention → Monitoring and Evaluation; diagnosis follows assessment.
Question 7: A client's food frequency questionnaire reveals high consumption of cruciferous vegetables. Which micronutrient interaction should the ISSA nutritionist flag as a potential concern for a client on anticoagulant therapy?
- Vitamin C interfering with iron absorption
- Vitamin K interfering with warfarin effectiveness (Correct answer)
- Beta-carotene interfering with vitamin A metabolism
- Folate interfering with B12 absorption
Correct answer: Vitamin K interfering with warfarin effectiveness
Cruciferous vegetables are rich in vitamin K, which antagonizes warfarin and can alter anticoagulation control if intake is inconsistent.
ISSA Nutrition Assessment & Client Evaluation 3
When using the dual-energy X-ray absorptiometry (DEXA) scan as a reference method for body composition, which compartment model does it primarily measure?