Registered Dietitian Nutritionist Registered Dietitian Nutritionist Nutrition Assessment & Counseling 2 — Questions and Answers
Question 1: In the Nutrition Care Process, how is a Nutrition Diagnosis documented?
- SOAP note format
- PES statement (Problem, Etiology, Signs/Symptoms) (Correct answer)
- ADIME format only
- SMART goal format
Correct answer: PES statement (Problem, Etiology, Signs/Symptoms)
A PES statement precisely names the nutrition problem, its root cause, and the clinical evidence supporting the diagnosis.
Question 2: Which method is considered the gold standard for measuring total energy expenditure in free-living individuals?
- 24-hour dietary recall
- Doubly labeled water method (Correct answer)
- Indirect calorimetry
- Harris-Benedict equation
Correct answer: Doubly labeled water method
The doubly labeled water method uses stable isotopes to accurately measure CO2 production and total energy expenditure over 1–2 weeks.
Question 3: In the Transtheoretical (Stages of Change) Model, which stage immediately precedes Preparation?
- Pre-contemplation
- Contemplation (Correct answer)
- Maintenance
- Action
Correct answer: Contemplation
Contemplation, where the person is aware of a need to change, precedes Preparation, where they plan to act within 30 days.
Question 4: Which dietary assessment method is most susceptible to recall bias?
- Food frequency questionnaire (FFQ) (Correct answer)
- 24-hour dietary recall
- Prospective food record/diary
- Direct observation
Correct answer: Food frequency questionnaire (FFQ)
The FFQ asks patients to estimate usual intake over months or years, making it the most vulnerable to recall inaccuracies.
Question 5: What is the primary limitation of using serum albumin as a nutritional marker in hospitalized patients?
- It has too short a half-life
- It is confounded by inflammation, hydration status, and liver disease (Correct answer)
- It is too costly to measure routinely
- It only reflects fat stores
Correct answer: It is confounded by inflammation, hydration status, and liver disease
Albumin is a negative acute-phase reactant; its levels fall during any inflammatory state independent of nutritional intake.
Question 6: Which behavioral change strategy involves having clients record their daily food intake, hunger cues, and eating circumstances?
- Cognitive restructuring
- Self-monitoring (Correct answer)
- Stimulus control
- Motivational enhancement
Correct answer: Self-monitoring
Self-monitoring through food diaries is one of the most evidence-supported behavioral strategies for promoting lasting dietary change.
Registered Dietitian Nutritionist Registered Dietitian Nutritionist Nutrition Assessment & Counseling 2
In the Nutrition Care Process, how is a Nutrition Diagnosis documented?