SNA Special Dietary Needs & Accommodations 2 — Questions and Answers
Question 1: Which of the following is NOT among the 'Big 9' major food allergens recognized by the FDA?
- Tree nuts
- Corn (Correct answer)
- Fish
- Wheat
Correct answer: Corn
Corn is not classified as a major food allergen by the FDA; the Big 9 are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame.
Question 2: Epinephrine auto-injectors (EpiPens) are the first-line emergency treatment for which condition in a school cafeteria setting?
- Severe hypoglycemia in a diabetic student
- Choking due to food aspiration
- Anaphylaxis from a severe allergic reaction (Correct answer)
- Foodborne illness symptoms
Correct answer: Anaphylaxis from a severe allergic reaction
Epinephrine is the primary and most effective treatment for anaphylaxis, a rapid and potentially fatal allergic reaction requiring immediate intervention.
Question 3: A student has Type 1 diabetes and an IEP. What is the school nutrition program's primary responsibility regarding meal service?
- Administer insulin injections before every meal
- Coordinate with the healthcare team and follow the individualized meal plan documented in the medical diet statement (Correct answer)
- Refuse service until blood glucose is within a normal range
- Automatically substitute all carbohydrates with protein alternatives
Correct answer: Coordinate with the healthcare team and follow the individualized meal plan documented in the medical diet statement
School nutrition staff must coordinate with the student's healthcare team and consistently follow the individualized accommodation plan documented by a licensed healthcare professional.
Question 4: What must a school nutrition program do upon receiving a student's medical diet statement?
- Implement changes immediately without review
- Forward it directly to the principal's office for filing only
- Notify USDA's Food and Nutrition Service within 24 hours
- Review, document, communicate to all relevant staff, and create an individualized meal plan (Correct answer)
Correct answer: Review, document, communicate to all relevant staff, and create an individualized meal plan
Upon receipt, the SNS must review the statement, create an individualized meal plan, ensure all relevant staff are informed, and maintain documentation for compliance.
Question 5: Which milk substitution is appropriate under the National School Lunch Program for a student whose medical diet statement documents lactose intolerance?
- Flavored almond milk
- Apple juice
- Lactose-free cow's milk (Correct answer)
- Carbonated water with added calcium
Correct answer: Lactose-free cow's milk
Lactose-free cow's milk meets the USDA fluid milk nutritional requirements and is an appropriate substitution for students with documented lactose intolerance.
Question 6: Which practice is most effective in preventing cross-contact for a student with a severe peanut allergy?
- Cooking all peanut-containing foods in a separate building
- Using color-coded utensils and dedicated preparation surfaces for allergen-free meals (Correct answer)
- Requiring all students to declare their allergies to the cashier daily
- Serving the allergic student last to minimize exposure time
Correct answer: Using color-coded utensils and dedicated preparation surfaces for allergen-free meals
Color-coded utensils and dedicated allergen-free preparation surfaces create a physical barrier that prevents allergen transfer, making them the most effective cross-contact prevention method.
Question 7: Under USDA guidance, who may authorize mandatory meal substitutions for a student with a disability?
- The school principal or district superintendent
- A licensed healthcare professional such as a physician, nurse practitioner, or physician assistant (Correct answer)
- A registered dietitian employed by the school district
- The student's parent or legal guardian
Correct answer: A licensed healthcare professional such as a physician, nurse practitioner, or physician assistant
USDA regulations require that meal substitutions for students with disabilities be authorized by a licensed healthcare professional with the clinical authority to diagnose and prescribe treatment.
SNA Special Dietary Needs & Accommodations 2
Which of the following is NOT among the 'Big 9' major food allergens recognized by the FDA?