Test Bank For Dental Hygienists Guide to Nutritional Care 4th Edition By Cynthia A

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Dental Hygienists Guide to Nutritional Care 4th Edition By Cynthia A – Test Bank 

 

Chapter 01: Overview of Healthy Eating Habits

Test Bank

 

MULTIPLE CHOICE

 

  1. Each of the following is true regarding designations for professionals in the field of nutrition except one. Which one is the exception?
a. A nutritionist usually works in a public health setting.
b. A registered dietitian (RD) must pass a national registration examination.
c. An RD who works in public health can call herself a registered dietitian nutritionist (RDN).
d. A dietetic technician, registered (DTR) works under supervision of a registered nurse.

 

 

ANS:  D

A dietetic technician, registered (DTR) normally works under the supervision of a registered dietitian. Like the registered dietitian, the DTR must pass a national registration examination and receive continuing education. Although the DTR can complete a 4-year curriculum, there also is a 2-year option. Regarding the distinction between the registered dietitian and the nutritionist, all registered dietitians are nutritionists, but not all nutritionists are registered dietitians.

 

REF:   p. 3

 

  1. Nutrition is the process by which living things use food to obtain nutrients for energy, growth and development. Energy is the measure of heat equivalent to 1000 calories needed to do work.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

The second statement confuses energy with the definition of a kilocalorie. Energy is the ability or power to do work. Kilocalories are related in that the potential energy value of foods within the body is expressed in terms of the kilocalorie. More frequently, the term calorie is used incorrectly. A kilocalorie (kcal) is a measure of heat equivalent to 1000 calories.

 

REF:   pp. 3-4

 

  1. Increase in consumption of which of the following has the greatest effect on an increase in body weight?
a. Carbohydrate intake
b. Protein intake
c. Fat intake
d. Total kilocalories

 

 

ANS:  D

There is little evidence that any individual calorie food group (carbohydrate, protein, fat) has a unique effect on body weight. Kilocalories are the key factor to controlling body weight—not the proportions of fat, carbohydrates, and protein, but balancing caloric intake with energy expenditure.

 

REF:   p. 6

 

  1. Each of the following is true regarding weight maintenance except one. Which one is the exception?
a. 1600 to 2400 kilocalories are recommended for adult women.
b. 2000 to 3000 kilocalories are recommended for adult men.
c. Kilocalories from alcohol do not count because they are expended rapidly.
d. A patient needing 2000 kcal/day should limit saturated fat intake to 20 g or less.

 

 

ANS:  C

Like energy-producing nutrients (carbohydrates, proteins, and fats), kilocalories from alcohol must be balanced with energy expenditure. In short, kilocalories from alcohol contribute to weight gain in the same manner as any other substance consumed.

 

REF:   p. 10 | p. 13

 

  1. Dietary guidelines recommend lowering caloric requirements for older adults because metabolic rate increases with age.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason are correct.

 

 

ANS:  C

Metabolic rate decreases with age. For this reason, the caloric requirements are lowered. Failure to lower the caloric intake without an accompanying increase in expenditure of energy will result in weight gain. For older individuals, this can be very serious because joint and cardiac function can be further stressed.

 

REF:   p. 4

 

  1. The terms calorie and kilocalorie are synonymous and can be used interchangeably. The term kilocalorie is an older term, often associated with the metric system.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The terms calorie and kilocalorie are not synonymous. Although they are used interchangeably, this is incorrect. They are both metric units and have different values. A kilocalorie is a measure of heat equivalent to 1000 calories. The term calorie is incorrectly used in discussing nutrition; kilocalorie is the appropriate term.

 

REF:   p. 4

 

  1. Each of the following nutrients provide energy except one. Which one is the exception?
a. Proteins
b. Carbohydrates
c. Fats
d. Vitamins
e. Alcohol

 

 

ANS:  D

Vitamins do not provide energy, nor do minerals. Although proteins, carbohydrates, fats, and alcohol provide energy, the body cannot use energy from the energy-containing components of food without adequate amounts of vitamins and minerals.

 

REF:   p. 4

 

  1. Increasing the variety of foods often causes nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Increasing the variety of foods is recommended to reduce the probability of developing isolated nutrient deficiencies, nutrient excesses, and toxicities resulting from nonnutritive components or contaminants in any particular food. For example, because red meats are an excellent source of iron and zinc, decreasing cholesterol intake by limiting these meats can reduce dietary iron and zinc intake.

 

REF:   p. 4

 

  1. Precursors are substances from which an active substance is formed. Nonessential nutrients cannot be synthesized from other substances.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Nonessential nutrients can be used by the body; they either are not required or can be synthesized from dietary precursors. Carotene is a precursor to vitamin A. It is found in fruits and vegetables and is converted to an active form of vitamin A by the liver.

 

REF:   p. 4

 

  1. Which nutrient is the most important?
a. Protein
b. Carbohydrate
c. Minerals
d. Water

 

 

ANS:  D

Water is the most important nutrient. After water, nutrients in highest priority are those that provide energy, which must be provided from foods or can be supplied from quantities stored in the body.

 

REF:   p. 4

 

  1. The human body has adaptive mechanisms that tolerate modest ranges in nutrient intakes. The metabolic rate usually increases to compensate for decreased caloric intake.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

The metabolic rate usually decreases to compensate for decreased caloric intake. This is an adaptive mechanism that “saves” energy for future needs in situations of decreased nutritional intake.

 

REF:   p. 4

 

  1. Healthy People (HP 2020), issued by the U.S. Department of Health and Human Services has resulted in a reduction of deaths from cardiovascular disease, stroke, and some cancers. It also has resulted in decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Although progress has been made in some areas, other areas show declines in health. Dental caries increased for the age groups identified in the question. There has also been an increase in the number of overweight and obese Americans, and little to no progress in the area of reducing health disparities for minority and low-income groups.

 

REF:   p. 5

 

  1. Each of the following accurately describe aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?
a. The DRIs replace the older recommended daily allowances.
b. Current DRIs attempt to estimate required nutrients to improve long-term health.
c. DRIs specifically address individuals whose requirements are affected by a disease state.
d. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

 

 

ANS:  C

The dietary reference intakes (DRIs) were intended for planning and assessing diets of healthy Americans and Canadians. They are inappropriate for malnourished individuals or patients whose requirements are affected by a disease state. The DRIs replace an earlier publication, the recommended daily allowances (RDAs). Note that there is also a new RDA which is intended as a goal for achieving adequate intakes.

 

REF:   p. 5

 

  1. Which set of guidelines is intended to assess nutrient adequacy or planning intakes of population groups, not individuals?
a. Old recommended dietary allowances (RDA)
b. Estimated average requirement (EAR)
c. New recommended dietary allowances (RDA)
d. Tolerable upper intake level (UL)

 

 

ANS:  B

The estimated average requirement (EAR) is the amount of a nutrient that is estimated to meet the needs of half of the healthy individuals in a specific age and gender group. This set of values is useful in assessing nutrient adequacy or planning intakes of population groups, not individuals.

 

REF:   p. 5

 

  1. The average amount of a nutrient that seems to maintain a defined nutritional state is measured by the:
a. recommended daily allowance (RDA).
b. estimated average requirement (EAR).
c. adequate intake (AI).
d. acceptable macronutrient distribution ranges (AMDR).

 

 

ANS:  C

To overcome shortcomings in both the EAR and the RDA, an AI was established. Derived from mean nutrient intakes by groups of healthy people and based upon scientific judgments, an AI is the average amount of a nutrient that seems to maintain a defined nutritional state. Values were established for various life stages for several nutrients, including fluoride. AMDRs were established for the macronutrients, fat, carbohydrate, protein, and two polyunsaturated fatty acids, to ensure sufficient intakes of essential nutrients.

 

REF:   p. 6

 

  1. Each of the following is true of the acceptable macronutrient distribution ranges (AMDRs) except one. Which one is the exception?
a. AMDRs were established to ensure sufficient intakes of the micronutrients.
b. One focus of the AMDRs is reduction of chronic disease.
c. Macronutrients are fat, carbohydrate, protein, and two polyunsaturated fatty acids.
d. Consuming amounts outside the AMDRs increases risk of insufficient intake of essential nutrients.

 

 

ANS:  A

AMDRs were established for the macronutrients, fat carbohydrate, protein, and two polyunsaturated fatty acids. The goal of the guideline is to ensure sufficient intakes of essential nutrients, while reducing risk of chronic disease.

 

REF:   p. 6

 

  1. Acceptable macronutrient distribution ranges (AMDRs) are expressed as a percentage of total energy intake, because an intake of each depends on intake of the others or of the total energy requirement of the individual. Increasing or decreasing one energy source while consuming a set amount of kilocalories affects the intake of the other sources of energy.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

An example of one source of energy being substituted for another: If an individual who routinely consumes 2,000 kcal decides to reduce amount of fat, either the protein or carbohydrate intake would need to increase proportionately.

 

REF:   p. 6

 

  1. The nutrient-based reference value that is defined as dietary energy intake predicted to maintain energy balance in healthy individuals of a defined age, gender, and weight is the:
a. acceptable macronutrient distribution ranges (AMDR).
b. estimated energy requirement (EER).
c. recommended daily allowance (RDA).
d. estimated average requirement (EAR).

 

 

ANS:  B

The estimated energy requirement (EER) is similar to the EAR. The major difference is that the EAR is the amount of a nutrient that is estimated to meet the needs of half of the healthy individuals in specific groups, whereas the EER addresses all healthy individuals in terms of age, sex, weight, height, and physical activity. Because energy requirement depends on activity level, four different activity levels are provided.

 

REF:   p. 6

 

  1. Each of the following is true regarding considerations that a dental hygienist must make when making dietary recommendations except one. Which one is the exception?
a. The dietary reference intakes (DRI) can be used as an assessment guide for all patients.
b. An individual’s exact requirement for a specific nutrient is not known.
c. The upper limits (ULs) can be used to warn patients of adverse effects of excessive intake of nutrients.
d. The DRIs are general guidelines and do not provide specific requirements.
e. Specific foods or groups of foods should be discussed rather than nutrients.

 

 

ANS:  A

DRIs are designed as an assessment guide for healthy patients only. These guidelines apply to average daily intakes, and they should be met by consuming a variety of foods whenever possible. Patients with specific illnesses or dietary imbalances should be referred to as registered dietitian.

 

REF:   pp. 5-6

 

  1. The 2010 Dietary Guidelines, released in 2011, reflect the preponderance of scientific evidence based on current nutrition-related health problems and contain technical information. MyPyramid, released with the 2010 publication, translates the dietary guidelines into a consumer-friendly form for the public.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

In 2010, the well-known food guide MyPyramid was replaced with MyPlate. This new food guidance system provides assistance in implementing the recommendations of the Dietary Guidelines and the DRI from the Institute of Medicine. MyPlate is a system that includes interactive websites and educational modules. This resource can be referenced at www.chooseMyPlate.gov.

 

REF:   p. 7

 

  1. Each of the following accurately describes features of MyPlate except one. Which one is the exception?
a. MyPlate replaces the well-known food guide, MyPyramid.
b. The interactive website is intended to help consumers apply personalized dietary guidance.
c. Whereas MyPyramid was more specific in many areas, MyPlate provides more general information.
d. Foods providing similar types of nutrients are grouped together and emphasizes proportionality of food selections.
e. MyPlate is designed as a food guidance tool for the general public.

 

 

ANS:  C

MyPlate provides more specific and personalized dietary guidance to help individuals achieve a healthful lifestyle through better eating and increased physical activity. It is more specific in certain areas than MyPyramid was. In addition, MyPlate is designed as a food guidance tool for the general public and not a therapeutic diet for any specific health condition.

 

REF:   p. 16

 

  1. The messages of MyPlate convey include each of the following except one. Which one is the exception?
a. Fruits and vegetables should fill half the plate.
b. Fruit juices should be consumed frequently.
c. Lean proteins foods should be chosen in moderation.
d. Whole grains should occupy about one fourth of the plate.
e. Physical activity is encouraged through the activity tab that has links to MyJournal.

 

 

ANS:  B

Although any fruit or 100% fruit juice counts as part of the fruit group, MyPlate suggests that people minimize fruit juice. Because of their fiber content, fresh, frozen, canned, or dried fruits are recommended. Note that the physical activity tab has links that discuss methods for incorporating an individualized exercise plan. The “Super Tracker” and MyJournal can help to plan, analyze, and track food intake and physical activity. Note that milk products, especially fat-free or low-fat, should be incorporated

 

REF:   p. 16

 

  1. Surveys show that most Americans eat only about half of the recommended vegetables per week. The high water and high-fiber content of vegetables counteract the low levels of cholesterol present in many dark-green vegetables.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Vegetables do not contain cholesterol. They are primary sources of the required nutrients dietary fiber, vitamin A (carotenoids), vitamin C, folic acid, and potassium. The total amount of red, orange, and dark-green vegetables recommended per week is 7 cups, but surveys show that most American eat only about 3.5 cups per week.

 

REF:   p. 18

 

  1. Which of the following food provides the most protein?
a. Beans
b. Red peppers
c. Asparagus
d. Celery

 

 

ANS:  A

Beans are an unusual vegetable because they are in both the vegetable and protein groups. Beans contain protein, fiber, calcium, folic acid, and potassium.

 

REF:   p. 18 | p. 19

 

  1. It is difficult for consumers to identify whole grain products, because labeling is inconsistent and color is a poor indicator.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

The difficulty in identifying whole grains is a major barrier to consuming adequate amounts of whole grains. Descriptive labels such as “100% wheat,” “stone ground,” and “multigrain” do not guarantee whole grain. In addition, color is a poor indicator because molasses or caramel food coloring may be added.

 

REF:   p. 19

 

  1. Each of the following is true of dietary considerations from the milk and milk product groups except one. Which one is the exception?
a. Fortified milk products are important sources of vitamin D.
b. Many mild substitutes are not fortified with vitamin D.
c. Children 2 to 3 years of age need 2 cups of milk daily.
d. Whole milk and many cheeses are high in unsaturated fat.

 

 

ANS:  D

Whole milk and many cheeses are high in saturated fat and can have negative health consequences. Low-fat or fat-free milk products provide little or no fat and should be chosen most often to avoid consuming more kilocalories than needed.

 

REF:   p. 19

 

  1. The dairy group includes butter and cream because they are high in calcium, riboflavin, and protein.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

High-fat products such as butter and cream are not included in the dairy products group, because they are not high in calcium, riboflavin, and protein.

 

REF:   p. 19

 

  1. Consumption of milk and milk products can promote the achievement of peak bone mass in children and adolescents. Studies indicate that higher dairy consumption is associated with decreased dental caries, but has no effect on periodontal disease.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Studies indicate that higher dairy consumption correlates with decreased prevalence and severity of both dental caries and periodontal health.

 

REF:   p. 19

 

  1. Current scientific evidence shows that most people consume only half the required amount of protein. Protein supplements promoted to increase muscle mass contain several amino acids not easily absorbed from foods.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Most people consume approximately twice as much protein as they need. Although this may not be harmful, high-fat meats may be an undesirable source of kilocalories, cholesterol, and fatty acids. Protein supplements do not contain nutrients important for health other than what foods provide. These should be used only after consulting a healthcare provider or registered dietitian.

 

REF:   p. 19

 

  1. Macronutrients include each of the following except one. Which one is the exception?
a. Fat
b. Polyunsaturated fatty acids
c. Carbohydrate
d. Protein
e. Vitamins

 

 

ANS:  E

Vitamins and minerals are considered micronutrients. Macronutrients are defined as being the classes of chemical compounds humans consume in the largest quantities and which provide bulk energy. Conversely, micronutrients are needed by the body in small amounts.

 

REF:   p. 19

 

  1. Which bread has the most magnesium?
a. Enriched white
b. Whole wheat
c. Whole grain
d. Rye

 

 

ANS:  B

Whole wheat bread has 23 mg of magnesium per serving whereas enriched white, whole grain, and rye contain 7, 20, and 13 mg respectively.

 

REF:   p. 14 | Table 1-2

 

  1. Each of the following daily reference values (DRVs) is correct except one. Which one is the exception?
a. Protein: 50 g
b. Carbohydrate: 300g
c. Total fat: <65 g
d. Sodium: <2400 mg
e. Fiber: 50 g

 

 

ANS:  E

The daily reference value for fiber is 25 g. Note that the daily reference values (DRVs) do not appear on the nutrient label. Instead the term daily value appears on the label for ease of understanding and reflects the DRV and the DRI standards to encourage a healthy diet. In addition, the DRI for protein has been established for certain groups. The 50 g of protein in the DRV is for adults and children older than 4 years of age only.

 

REF:   p. 24 | Table 1-6

 

  1. The process of restoring iron, thiamin, riboflavin, folic acid, and niacin removed during processing to approximately their original levels is called:
a. fortification.
b. enrichment.
c. satiety.
d. ghrelin.

 

 

ANS:  B

The process of restoring nutrients removed during processing is called enrichment. This process is controlled by the U.S. Food and Drug Administration (USDA), which establishes the quantity of nutrients that can be added. White bread is an example of a highly enriched product. Fortification is the process of adding nutrients not present in the natural product or increasing the amount above that in the original product. Satiety is the feeling of fullness provided by food. Fats provide more satiety than do lean proteins. Ghrelin is an appetite-stimulating hormone that is suppressed by proteins better than by carbohydrates and lipids.

 

REF:   p. 13

 

  1. The nutrient facts panel was established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. Nutrient content claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Two categories of claims currently can be used on food labels: nutrient content claims and health claims. Nutrient content claims describe the percentage of a nutrient in a product relative to the daily value. Health claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition.

 

REF:   p. 21

 

  1. Each of the following is true of terminology on food nutrition labels except one. Which one is the exception?
a. Daily reference values (DRVs) are the levels of nutrients considerable desirable for health.
b. A product’s nutrient profile is based on the percentage of DRVs, but the term daily value (DV) is used on the label.
c. For ease of standardizing the label, 2000 kcal is the reference amount for calculating the percentage of the DV in a serving.
d. The amounts for the nutrients are based on the daily value (DV).

 

 

ANS:  D

For ease of labeling, although nutrient label information uses the term daily value, the amounts for the nutrients are based on the reference daily intake (RDI). Recall that the RDI is usually larger than the RDA for a specific age/gender group.

 

REF:   p. 24

 

  1. Qualified health claims must be supported by qualified experts because although they are supported by some evidence, they do not meet the scientific standard.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct, but they are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason are correct.

 

 

ANS:  D

Health claims on foods are limited and regulated in an effort to protect consumers. Although qualified health claims are supported by some evidence, they do not meet scientific standards. For this reason, qualified claims must be accompanied by a disclaimer as specified by the U.S. Food and Drug Administration (FDA). Such a health claim must use the exact wording specified by the FDA. The other type of health claim, unqualified, must be supported by qualified experts agreeing that a relationship exists between the nutrient and product and a specific disease.

 

REF:   p. 25

 

  1. The Nutrition Facts Panel on brownie mix shows the following: 1 serving is one twentieth of the mix. Each serving contains 120 calories, 20 calories from fat, 17 g of sugar, and 10 g of protein. What is the approximate percentage of sugar in the brownie mix?
a. 17%
b. 27%
c. 57%
d. 73%

 

 

ANS:  C

Approximately 57% of the brownie mix is sugar. This is calculated by (1) multiplying the number of grams of sugar in a product by 4 kcal/g, (2) dividing this number by the total number of kilocalories per serving, and (3) multiplying by 100 to establish the percentage of calories as sugar. Note that the label incorrectly uses the term calorie; the correct term is kilocalorie.

 

REF:   p. 25

 

  1. Unsweetened juices and milk contain significant amounts of sugars because of the natural content of simple carbohydrates.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct, but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

This is confusing for some patients because both beverages are encouraged in appropriate amounts. Looking at “sugars” on the label can be misleading, whereas the total carbohydrate in the product more closely reflects actual carbohydrate content.

 

REF:   p. 27

 

  1. Each of the following is true of obesity except one. Which is the exception?
a. The prevalence of obesity is showing signs of leveling off.
b. During the past 20 years, the heaviest body mass index groups have been increasing at the fastest rates.
c. Statistics are more promising for ethnic groups because prevalence is less than in white Americans.
d. Hypertension, osteoarthritis, and elevated blood cholesterol accompany obesity.
e. Larger waist measurements are associated with increased health risks.

 

 

ANS:  C

Statistics are discouraging in ethnic groups (Hispanics, African Americans, Native Americans, and Alaska natives) because the prevalence of obesity is markedly higher than in white Americans.

 

REF:   pp. 28-30

 

  1. Each of the following is true regarding body weight in relation to height except one. Which one is the exception?
a. Currently, the body mass index (BMI) is the preferred method of defining body weight in relation to height.
b. BMI is determined mathematically by first dividing weight by height, dividing this number by height again, and multiplying this number by 703.
c. Chronic disease risk increases in most people with a BMI greater than 25.
d. Major ethnic differences exist regarding BMI.
e. BMI reveals significant details about overall body composition.

 

 

ANS:  E

Although BMI is the current preferred method of evaluating weight in relation to height, it has inherent weaknesses as a diagnostic guide. For example, a frail or inactive person with a normal-range BMI can have excess body fat and not appear out of shape. BMI reflects overall fat distribution and is cheap and quick. BMI is not appropriate for pregnant and nursing women, infants, and children younger than age 2 years, nor is it appropriate for some athletes with a large percentage of muscle.

 

REF:   pp. 9-10

 

  1. Each of the following are usual results of bariatric surgery except one. Which one is the exception?
a. Greater and sustained weight loss than conventional methods
b. Reduced incidence of diabetes
c. Reduced incidence and severity of cardiovascular disease
d. A shorter life span

 

 

ANS:  D

This drastic but effective measure typically results in a longer life because of the positive health effects that accompany sustained weight loss in obese patients. Side effects include altered absorption of many nutrients, pulmonary embolism, and some postoperative deaths.

 

REF:   p. 29

Chapter 03: The Alimentary Canal: Digestion and Absorption

Test Bank

 

MULTIPLE CHOICE

 

  1. Each of the following is a portion of the alimentary canal except one. Which one is the exception?
a. Oral cavity
b. Pharynx
c. Larynx
d. Esophagus
e. Small intestine

 

 

ANS:  C

The larynx is not a portion of the alimentary canal. This tubular structure is approximately 30 feet long and comprises all the body parts through which food passes.

 

REF:   p. 51

 

  1. The small intestine is comprised of the cecum, colon, and rectum. The large intestine includes the duodenum, jejunum, and ileum.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The statements are reversed. The small intestine is comprised of the duodenum, jejunum, and ileum. The large intestine includes the cecum, colon, and rectum.

 

REF:   p. 51

 

  1. Mechanical aspects of digestion include chewing and hypergeusia. Mechanical actions involve peristalsis, voluntary waves of contraction traveling the whole length of the alimentary tract.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Mechanical aspects of digestion include chewing and peristalsis. Peristalsis is a series of involuntary rhythmic waves of contraction traveling the whole length of the alimentary tract. Note that hypergeusia is a condition where the sense of taste is heightened.

 

REF:   p. 51

 

  1. Each of the following is true of enzymes except one. Which one is the exception?
a. Enzymes are complex proteins that are very specific.
b. Enzymes regulate metabolic reactions so that they proceed slowly and thoroughly.
c. Enzymatic reactions require a substrate.
d. Only small amounts of an enzyme is needed to complete a reaction.

 

 

ANS:  B

Enzymes enable metabolic reactions to proceed at a faster rate without being exhausted. Enzymes function similar to keys: they are highly specific and function on only one substrate, similar to a key fitting a particular lock. When the reaction is completed, the complex separates, releasing new chemical compounds and the enzyme.

 

REF:   p. 51

 

  1. Loss of smell results in a condition that limits capacity to detect flavor of food and beverages called:
a. hypergeusia.
b. dysgeusia.
c. anosmia.
d. phantom taste.
e. peristalsis.

 

 

ANS:  C

Anosmia, or loss of smell, results in limited capacity to detect flavor of food and beverage. Upper respiratory infections, nasal or sinus problems, and neurological disorders can cause anosmia. Hypergeusia is heightened taste acuity. Dysgeusia is persistent, abnormal distortion of taste. Phantom taste is dysgeusia without identifiable taste stimuli. Peristalsis is a mechanical action involved in digestion. It involves involuntary rhythmic waves of contraction in the alimentary tract.

 

REF:   p. 54

 

  1. Gluten sensitivity, an allergic condition, is an example of a systemic condition. Gluten sensitive patients develop impairment of the small intestine.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Gluten sensitivity is an example of a systemic condition because it qualifies as a disease or disorder that affects the whole body, but it is not an allergic condition. Gluten-sensitive patients can develop gastrointestinal symptoms, but the small intestine is not impaired. Gluten is a protein composite found in foods processed from wheat.

 

REF:   p. 54 | p. 62

 

  1. During peristalsis, doorlike mechanisms called valves or sphincter muscles perform all of the following functions except one. Which one is the exception?
a. Retain food in each segment until mechanical actions is complete.
b. Allow measured amount of food to pass to next segment.
c. Synthesize dietary enzymes necessary for chemical digestion.
d. Prevent food from “backing up” into the preceding area.

 

 

ANS:  C

Valves or sphincter muscles within the alimentary tract are strictly involved in mechanical aspects of digestion and do not synthesize dietary enzymes. An example of valvular peristaltic action is the small amounts of chyme that are released from the stomach through the pyloric sphincter to allow for adequate digestion and absorption in the small intestine. Regulation of these valves is complex, involving muscular function and different pressures on each side of the valve.

 

REF:   p. 51

 

  1. Food-drug interactions have the potential to cause nutritional problems. For example, consuming milk or milk products while taking amoxicillin decreases the amount of antibiotic and calcium available to the body.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Amoxicillin undoubtedly has other food-drug interactions, but it is tetracycline that interacts with milk and milk products. The result of this interaction is that lowered amounts of tetracycline and calcium are available to the body.

 

REF:   p. 52 | Dental Considerations

 

  1. The use of over-the-counter enzyme tablets might not be beneficial to patients because the enzymes within the product are digested before they can be used.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

Prescription enzymes are more likely to have protective features which prevent the active ingredient from being digested prior to the point at which it can be used. For example, prescription pancreatic enzymes have a special enteric coating preventing the enzyme from exposure to gastric juices. An example of an OTC product that has such a protective feature is lactase which is effective for lactose-intolerant because it is either added to or taken with lactose-containing foods.

 

REF:   p. 52 | Nutritional Directions

 

  1. Taste buds, receptors of taste located in the oral cavity, play an important role in the digestive system. Food choices are influenced by gustatory or visual sensations, taste, and smell.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Gustatory refers to taste, which is one of the three sensory perceptions that influence food choices. The remaining two are sight and smell. As food is chewed, gustatory receptors are exposed to chemicals dissolved in saliva.

 

REF:   p. 53

 

  1. Each of the following descriptions of taste papillae is true except one. Which one is the exception?
a. A taste bud consists of 30 to 100 papillae.
b. Taste papillae appear on the tongue as large red spots or small bumps.
c. Taste papillae are most numerous on the dorsal epithelium of the tongue.
d. Taste papillae replace themselves every 3 to 10 days.

 

 

ANS:  B

Taste papillae appear on the tongue as little red dots, or raised bumps. They are most numerous on the dorsal surface of the tongue, which is the top surface. Disease, drugs, nutritional status, radiation, and age can affect taste papillae.

 

REF:   p. 53

 

  1. It is not uncommon for an elderly patient to state that food “just doesn’t taste good,” because the impairment of the olfactory nerves is prevalent in older adults.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

Aromas stimulate olfactory nerves, which are receptors for smell. Prevalence of impairment of olfactory nerves is high in older adults, with the problem increasing with age.

 

REF:   p. 54

 

  1. Gustatory and olfactory disorders can result in deterioration of a patient’s general condition or nutritional status. Potentially adverse compensatory habits can contribute to dental caries and systemic conditions.
a. Both the statement and the reason are correct but are not related.
b. The statement is correct, but the reason is not correct.
c. The statement is not correct, but the reason is correct.
d. Neither the statement nor the reason is correct.

 

 

ANS:  A

It is not unusual for patients with impaired taste (gustatory) and smell (olfactory) senses to decline in health. In an effort to enjoy meals, many patients make compensatory changes such as adding of sugar and other sweeteners. These substances have detrimental health consequences, including dental caries and blood glucose disturbances. The addition of salt, another compensatory measure to improve the eating experience, negatively affects cardiovascular health.

 

REF:   p. 53 | p. 54

 

  1. Each of the following is a function of saliva except one. Which one is the exception?
a. Saliva is essential to gustatory sensations.
b. Saliva lubricates oral tissues.
c. Saliva provides antibacterial action.
d. Saliva buffers bacterial acids.
e. Saliva replaces calcium and phosphate in demineralized tooth surfaces with collagen.

 

 

ANS:  E

Saliva restores or returns calcium, phosphates, and other minerals into surfaces of teeth that have been damaged by caries, erosion, or abrasion. Saliva is supersaturated with calcium phosphates.

 

REF:   p. 55

 

  1. Saliva is supersaturated with bacterial by-products that allow demineralized areas of hydroxyapatite in enamel to be remineralized. Demineralization occurs when calcium, phosphate, and other minerals migrate from the enamel surface into the dentin.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Saliva is supersaturated with calcium phosphates that allow demineralized areas of hydroxyapatite in enamel to be remineralized. Remineralization is defined as the restoration or return of calcium phosphates and other minerals into damaged tooth surfaces. Demineralization occurs when calcium, phosphate, and other minerals are lost from tooth enamel, causing tooth enamel to dissolve.

 

REF:   p. 55

 

  1. Demineralization is a result of acids produced by fermentable carbohydrates combining with proteins to form prebiotics. Demineralization is caused by a lack of calcium intake or a calcium deficiency.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Demineralization is a result of acids produced by fermentable carbohydrates combining with acidogenic bacteria. It is not caused by lack of calcium intake or a calcium deficiency. Note that prebiotics are nondigestible food ingredients that have beneficial effects within the large intestine and colon.

 

REF:   p. 55

 

  1. Hydrolysis of a starch begins with which enzyme?
a. Salivary amylase
b. Pepsin
c. Pancreatic amylase
d. Sucrase

 

 

ANS:  A

Some chemical action or hydrolysis of nutrients begins in the mouth. Salivary amylase initiates starch digestion. If a carbohydrate, such as a cracker, is chewed and held in the mouth for a few seconds, it will begin to taste sweet. This denotes that some of the starch is being hydrolyzed to dextrin and maltose. Note that the name for many enzymes is derived from the name of its substrate, with the suffix -ase. Sucrase is the enzyme that hydrolyzes sucrose.

 

REF:   p. 55

 

  1. Digestion is accomplished solely through chemical activities on food because peristalsis permits blending of foodstuffs with digestive secretions.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  D

Digestion involves two basic types of action on food: mechanical and chemical. Mechanical actions include chewing and peristalsis, both of which break up and mix foods. The mechanical actions permit better blending of foodstuffs with digestion secretions.

 

REF:   p. 51

 

  1. The accessory organs include the large and small intestine. The role of accessory organs is to store foodstuffs during the digestive process.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The accessory organs are the salivary gland, liver, gallbladder, and pancreas. They provide secretions essential for digestion and absorption.

 

REF:   p. 51

 

  1. The maxilla and mandible need the forces of chewing to prevent calcium absorption. Chewing firm food helps to maintain a proper balance between bone breakdown and new bone formation within the alveolar process.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

The maxilla and mandible need chewing forces to prevent the resorption of calcium. Resorption breaks down a substance; absorption integrates a substance into the body. Calcium absorption is a desired process, whereas calcium resorption is not. The alveolar process is the crest of the maxilla and mandible that serves as the bony investment for the teeth.

 

REF:   p. 55

 

  1. Missing teeth increase the potential for food obstruction in the airway, because an inability to masticate food can result in larger chunks of food being swallowed.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

The act of chewing reduces food particle size. An inability to masticate food adequately can result in large chunks of food being swallowed, which increases the potential for food obstruction in the airway. Loss of even one permanent molar can decrease masticatory efficiency, which is defined as how well a patient prepares food for swallowing.

 

REF:   p. 56

 

  1. Masticatory efficiency refers to enhancement of gustatory effects. Even after a patient becomes fully adjusted to well-fitted dentures, masticatory efficiency is reduced compared with that of patients with their natural teeth.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Masticatory efficiency refers to how well a patient prepares food for swallowing. Gustatory sensations, more commonly known as the sense of smell, are intricately involved with appetite, but this is not definitive of masticatory efficiency. When masticatory efficiency declines, people frequently choose foods that require less chewing or they use techniques to soften foods, such as stewing meats, steaming vegetables, or dunking cookies in fluids.

 

REF:   p. 56

 

  1. Each of the following is true of swallowing and processing food except one. Which one is the exception?
a. The swallowing reflex moves a bolus into the esophagus.
b. A bolus is a mass of food.
c. The bolus is transported to the stomach by osmosis and gravity.
d. The bolus penetrates the diaphragm through the esophageal hiatus.
e. The lower esophageal sphincter relaxes to permit food into the stomach.

 

 

ANS:  C

The bolus is transported to the stomach by peristalsis and gravity. Peristalsis is a series of contractile waves that mechanically move the bolus through the alimentary tract. Note that osmosis is the passage of water through a semipermeable membrane to equalize osmotic pressure. This process involves ionic control of movement of water (fluids) across membranes.

 

REF:   p. 56

 

  1. The lower esophageal sphincter is a bony structure located within the stomach. It relaxes to permit food to move within the stomach on its way to the intestines.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The lower esophageal sphincter comprises a group of strong circular muscle fibers located just above the stomach. The lower esophageal sphincter relaxes to permit food into the stomach.

 

REF:   p. 56

 

  1. In a well-functioning alimentary tract, stomach contents do not “back wash” into the esophagus, because the pyloric sphincter prevents foodstuff from seeping back into the esophagus.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

When all components are functioning correctly, the lower esophageal sphincter prevents backwash of foodstuff (chyme). The pyloric sphincter performs a similar task in a different location. It releases small amounts of chyme from the stomach into the small intestine for digestion and absorption.

 

REF:   p. 57

 

  1. A patient who reports stomach ulcers should avoid all the following foods except one. Which one is the exception?
a. Proteins
b. Caffeine
c. Calcium
d. Wheat

 

 

ANS:  D

Patients with ulcers of certain gastrointestinal tract disorders should avoid dietary constituents that increase hydrochloric acid and pepsin secretion. Foods to avoid include proteins, calcium, caffeine, coffee, and alcohol. Conversely, wheat (a whole grain), brown rice, and pastas are usually well tolerated because they do not typically stimulate gastric secretions. Note that although wheat is problematic in patients with gluten sensitivity, it is not contraindicated in patients with ulcers.

 

REF:   p. 57 | Dental Considerations

 

  1. An adult stomach functions as a reservoir to hold an average meal for 6 to 8 hours. The rate of passage through the stomach (fastest to slowest) is liquids, proteins, carbohydrates, and fats.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

An adult stomach functions as a reservoir to hold an average meal for 3 to 4 hours. The stomach empties at different rates depending on its size and the composition of the chyme. The rate of passage, fastest to slowest, is liquids, carbohydrates, proteins, and fats. Note that fats remain in the stomach longer, increasing satiety for a longer time than proteins or carbohydrates.

 

REF:   p. 57

 

  1. Most absorption occurs in the stomach because the gastric juices secreted by the stomach effectively hydrolyze and prepare nutrients for absorption.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

Very little absorption occurs in the stomach because few foods are completely hydrolyzed to nutrients the body can use at this stage. Nutrients that can be absorbed from the stomach include some water, alcohol, and a few water-soluble substances such as amino acids and glucose. Most of the energy-providing nutrients are completely hydrolyzed and absorbed within the small intestine.

 

REF:   p. 57

 

  1. Which of the following is most likely to be absorbed within the stomach?
a. Carbohydrates
b. Fats
c. Amino acids
d. Fat-soluble vitamins

 

 

ANS:  C

Most of the energy-providing nutrients are completely hydrolyzed and absorbed within the small intestine. The only nutrients completely absorbed within the stomach are water, alcohol, and a few water-soluble substances such as amino acids and glucose. Note that little absorption occurs in the stomach because few foods are completely hydrolyzed to nutrients that the body can use at this point.

 

REF:   p. 58

 

  1. Each of the following accurately describes aspects of the villi except one. Which one is the exception?
a. Fingerlike projections called villi rise from the intestinal lumen.
b. Villi decrease the surface area of the alimentary tract by contraction and compression.
c. Each villus is covered with a layer of epithelial cells called microvilli.
d. The brush border of cells is formed by microvilli.

 

 

ANS:  B

Villi increase the surface area of the alimentary tract to approximately 3000 square feet. Note that microvilli are minute cylindrical processes located on the surface of intestinal cells, greatly increasing their absorptive surface area.

 

REF:   p. 57

 

  1. Intestinal digestion of fats and insoluble molecules is enhanced because emulsification by bile salts facilitates breakdown of such substances in to smaller particles.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

This question accurately describes emulsification, or breakdown of fats and soluble substances within the intestine. Importantly, emulsification allows greater exposure of fats to intestinal and pancreatic lipases. Peristalsis facilitates mixing and emulsification processes.

 

REF:   p. 57

 

  1. Pancreatic enzymes enter the colon through the pancreatic duct. Produced and stored in the pancreas, these enzymes hydrolyze carbohydrates, proteins, and fats. Note that proteolytic enzymes, specifically designed to hydrolyze proteins, are also produced and stored in the pancreas.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Pancreatic enzymes enter the duodenum through the pancreatic duct. The duodenum is the first section of the small intestine.

 

REF:   p. 57

 

  1. Proteolytic enzymes are most likely to break down which food type?
a. Carbohydrates
b. Proteins
c. Fats
d. Lipids

 

 

ANS:  B

Proteolytic enzymes target and break down proteins. Notice that the names of most enzymes begin with the type of food it targets and end in -ase. For example, lipase breaks down fats, also known as lipids. Other enzymes, such as pancreatic enzymes, contain the full name of the organ from which it originates.

 

REF:   p. 57

 

  1. Passage of a permeable substance from a more concentrated solution to an area of lower concentration is called osmosis. Transport requiring a carrier and cellular energy is active transport.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Osmosis, active transport, and passive diffusion are three mechanisms that aid in transporting materials during absorption of nutrients. Passage of a permeable substance from a more to a less concentrated solution is called passive diffusion. Osmosis is the passage of water through a semipermeable membrane to equalize osmotic pressure exerted by ions in solutions. Active transport is accurately described in the question.

 

REF:   p. 59

 

  1. Nutrients are absorbed from the small intestine through the mucosa into the portal circulation. Nutrients are transported through the portal vein to the liver where metabolism is initiated.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  A

The portal circulation enables passage of nutrients from the gastrointestinal tract and spleen through the portal vein to the liver. Most nutrients are absorbed from the small intestine through the mucosa into the portal circulation. The portal circulation delivers the nutrients to the liver where metabolism is initiated.

 

REF:   p. 59

 

  1. Most nutrients are absorbed from the small to the large intestine, where the majority of digestion occurs. As the large intestine reabsorbs water and electrolytes, it forms the residue, also called feces.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Almost no absorption occurs in the large intestine; most absorption occurs in the small intestine. The large intestine forms and stores the residue, or feces, until defecation. Residue in the intestinal tract is defined as the total amount of fecal solids.

 

REF:   p. 59

 

  1. Each of the following is true of microflora within the colon except one. Which one is the exception?
a. Approximately 50 different species of microorganisms compose the microflora.
b. Microflora break down substances that human enzymes are unable to digest.
c. Vitamin K and numerous B vitamins are synthesized by the microflora.
d. Microflora inhibit pathogenic bacteria.

 

 

ANS:  A

More than 1 trillion harmless bacteria thrive in the colon. Approximately 400 different species or microorganisms compose the microflora within the colon. Proliferation of pathogenic, or harmful, bacteria is inhibited by the protective features of the microflora. Types of food and medications ingested influence the type, activity, and relative numbers of bacteria. When intestinal flora is unbalanced, overall health can be affected.

 

REF:   p. 60

 

  1. Each of the following is true of protective elements within the microflora except one. Which one is the exception?
a. Prebiotics are food ingredients that must be digested to stimulate growth and activity of microorganisms.
b. Probiotics are living microorganisms that are considered food or dietary supplements in the United States.
c. Symbiotics are a combination of prebiotics that support growth of probiotics.
d. Probiotics are helpful in managing and treating constipation.

 

 

ANS:  A

Prebiotics are nondigestible food ingredients that have beneficial effects on the host by selectively stimulating the growth or activity, or both, of beneficial colonic microorganisms. Stated succinctly, prebiotics are food for probiotics. Probiotics together with prebiotics that support their growth are called symbiotics because they work together to promote probiotic benefits more efficiently. Although probiotics can help to regulate bowel habits and relieve constipation, they are frequently used to treat diarrhea and to prevent irritable bowel syndrome. Constipation means having a bowel movement fewer than three times per week with hard, dry, difficult-to-pass stools.

 

REF:   pp. 60-61

 

  1. Each of the following is true of wheat sensitivity except one. Which one is the exception?
a. Celiac disease is an autoimmune disorder caused by permanent gluten sensitivity.
b. If not treated, celiac disease damages the microvilli in the small intestine.
c. Gluten sensitivity is both an allergic reaction and an autoimmune disorder.
d. Celiac disease is more common in people of European origin.

 

 

ANS:  C

Celiac disease and gluten sensitivity are two different conditions related to ingestion of gluten. Gluten is the structural protein component of the grains wheat, rye, barley, and triticale (a cross between wheat and rye). Whereas celiac disease is an autoimmune disorder, gluten sensitivity is neither allergic nor immunologic. Gluten-sensitive individuals are unable to tolerate gluten and can develop gastrointestinal symptoms, but the small intestine is not impaired (as is the case with celiac disease). A third category exists in which the patient develops an allergy to wheat.

 

REF:   pp. 62-63

 

  1. Alveolar bone is primarily composed of bony spikes forming a meshwork of spaces within cancellous bone. This spikelike formation is called interdental bone.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

The spikelike formation of bone that forms a meshwork of spaces within cancellous bone is called trabecular bone. Cancellous bone is internal bone that appears spongy with little hollows that contain bone marrow.

 

REF:   p. 55

 

  1. Lactose-intolerant individuals have a deficiency of both lactase and sucrase because breakdown of lactose involves conversion into two monosaccharides.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  D

Lactose intolerance is associated with a deficiency of lactase only. Although lactose is converted into two monosaccharides before exposure to gastric juices, the enzyme sucrose is not crucial. Note that sucrase is an enzyme necessary for proper metabolism of sucrose (sugar).

 

REF:   p. 52 | Nutritional Directions

 

  1. Each of the following statements describes functions of the small intestine except one. Which one is the exception?
a. Complete hydrolysis of most energy-providing nutrients
b. Absorption of most vitamins and minerals
c. Enzymatic breakdown of cellulose
d. Secretion of digestive juices from its luminal wall

 

 

ANS:  C

Cellulose, a carbohydrate found in plants, cannot be completely digested because the human body lacks enzymes that can hydrolyze and break it down.

 

REF:   p. 51

 

  1. Bile is produced and secreted by the liver and stored in the small intestine. Production of bile is stimulated by salivary amylase.
a. Both statements are false.
b. Both statements are true.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Bile is produced and secreted by the liver and stored in the gallbladder. Production of bile is stimulated by cholecystokinin, a hormone released in response to fat in chyme. Note that acidic chyme entering the intestine stimulates hormones to release pancreatic juices.

 

REF:   p. 57

 

  1. The basic hydrolysis reactions necessary for food digestion depend upon sugars because these complex carbohydrate-based substances enable completion of metabolic reactions at an efficient rate.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

The basic hydrolysis reactions depend on enzymes, because these complex proteins are responsible for enabling completion of metabolic reactions at a fast rate without exhausting themselves.

 

REF:   p. 51

 

  1. Each of the following is true of carbohydrate digestion except one. Which one is the exception?
a. Digestion begins with salivary amylase.
b. Hydrolysis begins within the mouth.
c. Ptyalin is an enzyme involved in carbohydrate digestion.
d. Xerostomia increases digestive function.

 

 

ANS:  D

Xerostomia, dry mouth from inadequate salivary section, leads to diminished digestive function. Much digestion, including that of carbohydrates, begins in the mouth with the action of salivary amylase. Note that this digestive enzyme, also called ptyalin, initiates starch digestion.

 

REF:   p. 57

 

  1. Which substance is most essential for hydrolyzing large protein molecules?
a. Gastric lipase
b. Pepsin
c. Mucus
d. Intrinsic factor

 

 

ANS:  B

Although many enzymes are involved in hydrolysis and digestion, pepsin is essential for hydrolysis large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Gastric lipase is involved in digestion of short-and medium-chain triglycerides. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12.

 

REF:   p. 57

 

  1. Which enzyme is most essential for digestion of triglycerides found in butterfat?
a. Gastric lipase
b. Pepsin
c. Mucus
d. Intrinsic factor

 

 

ANS:  A

Gastric lipase is essential for digestion of short- and medium-chain triglycerides, such as those found in butter fat. Pepsin is essential for hydrolysis of large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12.

 

REF:   p. 57

Chapter 09: Minerals Essential for Calcified Structures

Test Bank

 

MULTIPLE CHOICE

 

  1. Bones contain one third of the body’s magnesium. It is the third most prevalent mineral in teeth.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Bones contain almost two thirds of the body’s magnesium. Although dentin is the third most prevalent mineral in teeth, it contains about twice the amount of magnesium as enamel.

 

REF:   p. 166

 

  1. The best source of phosphorus is:
a. whole-grain products.
b. fruits and vegetables.
c. legumes.
d. animal protein.
e. soy protein.

 

 

ANS:  D

Animal proteins provide the most phosphorus per milligram consumed. For example, Romano and Swiss cheeses provide 905 mg and 673 mg, respectively, whereas cooked spinach and instant fortified oats provide 122 mg and 187 mg of phosphorus, respectively.

 

REF:   p. 164

 

  1. In which situation is fluoridated drinking water most likely to result in mild fluorosis?
a. 1 ppm in a 4 year old
b. 3 ppm in a 6 year old
c. 8 ppm in a 7 year old
d. 10 ppm in an 18 year old
e. 10 ppm in an older adult

 

 

ANS:  B

The U.S. Department of Health and Human Services Agency and the Environmental Protection Agency suggests drinking water contain approximately 0.7 parts per million (PPM) of fluoride (equivalent to 1 mg/L). This concentration must be slightly adjusted for climate. In warmer climates where more water is consumed, the concentration should be decreased slightly. The concentration of 3 ppm in a 6 year old is the most likely selection to result in mild fluorosis because 1 ppm is unlikely to cause fluorosis, and concentrations greater than 4 ppm produce more severe effects including brown stains.

 

REF:   p. 173

 

  1. Each of the following is true of collagen as it relates to bone mineralization and growth except one. Which one is the exception?
a. Collagen is a protein matrix.
b. Dentin, cementum, and bone originate with collagen deposition.
c. Collagen is the primary connective tissue fiber in the gingiva.
d. Collagen is the major organic constituent of alveolar bone.
e. Collagen is inorganic.

 

 

ANS:  E

Collagen is an organic protein matrix that is the basis for dentin, cementum, and bone. This matrix is present throughout the periodontium as the primary connective tissue fiber in the gingiva and the major organic constituent of alveolar bone.

 

REF:   p. 161

 

  1. When collagen is formed, apatite, a complex composed of osteoclasts and osteoblasts, automatically crystallizes adjacent to the collagen fibers. Formation of collagen requires the presence of protein, vitamin C, and minerals.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Apatite is calcium phosphate complex that automatically crystallizes adjacent to collagen fibers as they are formed. The minerals required for the formation of collagen are iron, copper, and zinc. Osteoblasts are cells that form bone; osteoclasts are cells that break down (absorb) bone.

 

REF:   p. 161

 

  1. Mineralization of bone begins prior to collagen formation. Mineralization is the deposition of organic elements on an inorganic matrix.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Mineralization of bone begins immediately after collagen formation. Mineralization is the deposition of inorganic elements (minerals) on an organic matrix. The organic matrix is composed mainly of protein in combination with some polysaccharides and lipids.

 

REF:   p. 161

 

  1. Each of the following is true of formation of teeth except one. Which one is the exception?
a. Teeth are composed of enamel, dentin, and cementum.
b. Approximately 20% of enamel is organic material.
c. Dentin lacks the osteoblasts and osteoclasts found in bone.
d. Enamel and dentin do not contain blood vessels or nerves.

 

 

ANS:  B

Only 1% of the enamel is organic material. Approximately 20% of dentin, cementum, and bone are organic material, principally collagen. Collagen fibers make teeth tough and resistant to tensional forces. Tensional forces are actions in which the pressure stretches or strains the structure.

 

REF:   p. 161

 

  1. Actions in which pressure stretches or strains the structure are referred to as compressional forces. Tensional forces are actions in which pressure attempts to increase a structure’s volume.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The definitions are reversed. Actions in which pressure attempts to diminish a structure’s volume are referred to as compressional forces (think compression equals making something smaller). Conversely, tensional forces are actions in which the pressure stretches or strain the structure. As with bone, the mineral crystallization structure makes teeth extremely resistant to forces. Collagen fibers also play a major role.

 

REF:   p. 161

 

  1. The crystalline structure of enamel makes it:
a. insoluble and resistant.
b. soluble and resistant.
c. insoluble and softer than dentin.
d. soluble and harder than dentin.

 

 

ANS:  A

The crystalline structure of enamel makes it insoluble and resistant to the many forces within the mouth. Enamel is harder than dentin; it is also harder than cementum.

 

REF:   p. 161

 

  1. Nourishment for the dentin is provided by:
a. bioavailable calcium.
b. odontoblasts.
c. phosphorus.
d. osteoid.

 

 

ANS:  B

Odontoblasts line the inner surface of the dentin and provide nourishment for dentin. Bioavailable calcium is the form of calcium available for absorption and utilization by the cells and tissues of the body. Phosphorus, the second most abundant mineral in the body has many functions, but it does not nourish the dentin. Osteoids are bones that have not undergone calcification.

 

REF:   p. 161

 

  1. Each of the following is true of calcium within the saliva except one. Which one is the exception?
a. Saliva is supersaturated with calcium.
b. Saliva is a source of calcium to mineralize an immature of demineralized enamel surface.
c. Calcium and phosphate in saliva provide a buffering action.
d. Calcium within saliva increases dental caries.

 

 

ANS:  D

The buffering action provided by calcium and phosphate in saliva inhibit caries formation by preventing dissolution of enamel by plaque biofilm.

 

REF:   p. 162

 

  1. Despite wide variations in calcium intake, serum calcium is relatively constant because each cell has a vital need for calcium.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

If the serum calcium level declines, bones are used as calcium reserves. When calcium withdrawal from bones exceeds deposits, calcium imbalance occurs.

 

REF:   p. 163

 

  1. The serum calcium-to-phosphorus ratio is an inverse relationship. If the calcium level increases, the phosphorus level will increase to match this level.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

An inverse relationship between two minerals means that as levels of one increase, levels of the other rise. In the case of the calcium-to-phosphorus ratio, if the calcium level increases, the phosphorus level decreases, and vice versa. This relationship is a protective mechanism which presents high combined concentrations of the two minerals. Subsequent calcification of soft tissue and stone formation could occur if calcium and phosphorus had a direct relationship.

 

REF:   p. 163

 

  1. The ideal dietary calcium-to-phosphorous ratio for adults is 2:1. This ratio enables osteoclasts to deposit bone in areas weakened by stress.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

The ideal dietary calcium-to-phosphorous is 1:1. This ratio acts as a protective mechanism to prevent high combined concentrations of one mineral in excess of the other. Such maldistribution would enable calcification of soft tissues and stone formation within areas such as salivary glands and the kidneys.

 

REF:   p. 163

 

  1. Which of the following does not enhance absorption of calcium supplements?
a. Sucrose
b. Dextrose
c. Lactose
d. Mineral oil

 

 

ANS:  D

Mineral oil and some laxatives can decrease calcium absorption. Conversely, calcium supplements absorption can be enhanced if taken with some form of sugar.

 

REF:   p. 167 | Nutritional Directions

 

  1. During growth periods, the requirement for calcium is unchanged because peak bone mass seems related to depletion of calcium reserves.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

During growth periods, the requirement for calcium is increased because peak bone mass seems related to calcium intake during periods of bone mineralization.

 

REF:   p. 162

 

  1. Most of adult bone mass is acquired in girls by age:
a. 12.
b. 15.
c. 18.
d. 21.

 

 

ANS:  C

Approximately 85% to 90% of adult bone mass is acquired by the age of 18 years in girls; it occurs by 20 years of age in boys.

 

REF:   p. 162

 

  1. Adequate intake of calcium is observed in males and females from 20 to 35 years. Women can continue to increase bone growth and density through their 20s, but do not achieve the bone mass level observed in most men.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Adequate intake of calcium is observed in men and women from 20 to 59 years of age. Between age 30 years and menopause, women tend to maintain bone mass; however, bone mass loss accelerates after menopause.

 

REF:   p. 162

 

  1. Inadequate calcium intake can be attributed to each of the following except one. Which one is the exception?
a. Uninformed choices
b. The belief that adults do not need milk
c. The belief that milk contributes too many calories
d. Lactose intolerance
e. Economic hardships

 

 

ANS:  D

Individuals who are lactose intolerant can obtain calcium from many sources other than dairy. Soy milk, fortified orange juice, and calcium supplements for lactose intolerance are a few examples of calcium sources. There is a mistaken belief that adults do not need milk and that it contributes too many kilocalories to the diet. These mistaken beliefs keep many people from consuming adequate amounts of dietary calcium.

 

REF:   p. 166

 

  1. Inadequate calcium and vitamin D intake during tooth formation and maturation can result in hypomineralization of developing teeth. Generally, inadequate calcium intake affects bone mass and tooth structure equivalently.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Generally, inadequate calcium intake affects bone mass more than tooth structure.

 

REF:   p. 162

 

  1. Each of the following is true of the calcium-to-phosphorus ratio except one. Which one is the exception?
a. Serum (blood) calcium is relatively constant.
b. Each cell has a vital need for calcium.
c. Calcium imbalance occurs when calcium withdrawal from bones exceed deposits.
d. Decreased bone density caused by insufficient calcium occurs rapidly.

 

 

ANS:  D

Decreased bone density caused by insufficient calcium is a slow process. Despite wide variation in calcium intake, serum calcium is relatively constant because each cell has a vital need for calcium.

 

REF:   p. 163

 

  1. Calcium balance, an intake that equals excretion, depends solely on adequate calcium intake. Although hormones such as PTH are involved in phosphorus balance, hormonal influence on calcium balance is insignificant.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Calcium balance does not depend solely on adequate calcium intake. Several hormones, including parathyroid hormone (PTH), estrogen, glucocorticoids, and thyroid hormone help to regulate calcium absorption.

 

REF:   p. 163 | p. 164

 

  1. Individuals should consume 30% of the daily value or 300 mg of calcium per serving three or four times daily because under normal conditions, less than one third of the calcium consumed is absorbed.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

Calcium is best absorbed by the body when consumed in smaller amounts and ingested several time throughout the day.

 

REF:   p. 163

 

  1. Milk and other dairy products are preferred sources of calcium because lactose enhances calcium absorption.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

Milk and other dairy products supply most of the available calcium, so they are the preferred sources of calcium. Not only are dairy products naturally high in calcium content, their inherent lactose and other nutrient content enhance calcium absorption. Milk also provides other essential nutrients.

 

REF:   p. 164

 

  1. Patients with achlorhydria (absence of hydrochloric acid in the stomach) should not take calcium with meals. Mineral oils and some laxatives can decrease calcium absorption.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Patients with achlorhydria (absence of hydrochloric acid in the stomach) might not absorb calcium supplements on an empty stomach and should take them with meals. Although mineral oil and some laxatives can decrease calcium absorption, forms of sugar such as lactose, dextrose, and sucrose enhance calcium absorption.

 

REF:   p. 166

 

  1. Calcium supplements combined with vitamin D result in small but significant reductions in bone loss. Benefits of this combination are significant because the bioavailability of both vitamin D and calcium is enhanced in combined supplements.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

The benefits of combined vitamin D and calcium supplementation are less than expected, because of the limited bioavailability of supplemental calcium. Bioavailability refers to the amount of a nutrient available physiologically based on its absorption rate.

 

REF:   p. 164 | p. 165

 

  1. Each of the following is true of calcium supplements except one. Which one is the exception?
a. A calcium supplement contains elemental calcium along with other substances.
b. Calcium carbonate is 40% calcium by weight.
c. Calcium citrate is 75% calcium by weight.
d. Calcium-citrate-malate is a form of calcium in supplements or fortified foods.

 

 

ANS:  C

Calcium citrate is 21% calcium by weight. Other forms of calcium in supplements or fortified foods include calcium gluconate, calcium sulfate, and calcium lactate.

 

REF:   p. 165

 

  1. Hypercalcemia, high levels of calcium in the blood, is almost always caused by excess dietary calcium intake. This can result in renal proliferation and increased kidney function.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Hypercalcemia is increased level of calcium in the blood. Rarely the result of dietary intake, hypercalcemia can result in renal insufficiency, kidney stones or hypercalciuria (high levels of calcium in the urine).

 

REF:   p. 165

 

  1. High levels of calcium within the kidneys is called:
a. hypercalcemia.
b. hypercalciuria.
c. hyperplasia.
d. hypoplasia.

 

 

ANS:  B

An increased level of calcium within the kidneys is called hypercalciuria. Hypercalcemia is high levels of calcium within the blood. Hyperplasia is an increase in cell size, whereas hypoplasia is a decrease in cell size.

 

REF:   p. 165

 

  1. Hypocalcemia, or deficient levels of calcium in the blood, can be caused by overdoses of cholecalciferol or excessive amounts of vitamin D preparations. Hypocalcemia results in tetany, a neuromuscular disorder.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Hypocalcemia, is not caused by cholecalciferol. Depressed serum calcium levels (hypocalcemia) may be caused by hypoparathyroidism, some bone diseases, certain kidney diseases, and low serum protein levels. It is true that hypoglycemia results in tetany, a neuromuscular disorder of uncontrollable cramps and tremors involving the muscles of the face, hands, feet, and eventually the heart. Note that overdoses of cholecalciferol, vitamin D3, can cause hypercalcemia.

 

REF:   p. 166

 

  1. Rickets cannot occur when calcium levels are sufficient because formation of rickets is solely dependent upon blood (serum) calcium level.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

Rickets results in porous, soft, and sometimes twisted bones. It is the result of an inadequate amount of calcium deposits in the bone during childhood. Interestingly, rickets can occur during times of adequate calcium intake if vitamin D is insufficient, because absorption and utilization of calcium is dependent on adequate vitamin D levels.

 

REF:   p. 166

 

  1. Each of the following is true of osteoporosis except one. Which one is the exception?
a. Osteoporosis is an age-related disorder.
b. It is characterized by decreased bone mass.
c. Increased estrogen during perimenopause is a strong causative factor.
d. Weight-bearing exercise is thought to be a preventive factor.

 

 

ANS:  C

Osteoporosis is caused by numerous factors including decreased estrogen, inadequate calcium or vitamin D intake, and lack of weight-bearing exercise. It is an age-related disorder that is characterized by decreased bone mass.

 

REF:   p. 166

 

  1. Periodontal disease, the breakdown of healthy gingival tissue, can be exacerbated by a deficiency of calcium. Oral signs of osteoporosis may include increased density of the lamina dura.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Periodontal disease is the breakdown of healthy periodontal tissue and not specifically the gingival tissues. Periodontal tissues include the gingiva, alveolar bone, cementum, periodontal and gingival fiber networks, and the periodontal ligament. It is true that the breakdown of periodontal tissues is exacerbated by osteoporosis. Oral signs of osteoporosis can include loss of calcium in the alveolar bone. The lamina dura, the radiolucent area adjacent to the periodontal ligament, does not increase in density. Any effects related to osteoporosis would be degenerative.

 

REF:   p. 166

 

  1. Each of the following is true of phosphorus except one. Which one is the exception?
a. Phosphorus is the second most abundant mineral in the body.
b. Phosphorus is mainly found in the muscles and bone.
c. It is responsible for transfer and release of energy.
d. It is involved in metabolism of fats, carbohydrates, and proteins.

 

 

ANS:  B

Phosphorus, the second most abundant mineral in the body, is present in all body cells and is necessary for almost every aspect of metabolism. It is vital to transfer and release of energy stores as adenosine triphosphate (ATP, composition of phospholipids, DNA, and RNA).

 

REF:   p. 167

 

  1. Which percentage most approximates the dietary phosphorus absorbed in the jejunum?
a. Less than 20%
b. 20% to 30%
c. 40% to 50%
d. 60% to 70%
e. More than 70%

 

 

ANS:  D

Approximately 60% to 70% of dietary phosphorus is absorbed in the jejunum. Its absorption can be inhibited by the same dietary factors affecting calcium absorption: phytate, excessive amounts of fats, iron, aluminum, and calcium. Note that the jejunum is the middle part of the small intestine.

 

REF:   p. 167

 

  1. Consumption of soft drinks is often recommended to increase serum phosphorus levels. Hyperphosphatemia can be a risk factor cardiac disease.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Consumption of more than two to three cans of soft drink daily in place of mild can interrupt the calcium-to-phosphorus balance. Adequate intake of phosphorus from dairy products is thought to control blood pressure. Note that phosphorus is widespread in foods, and a deficiency is unlikely. Soft drinks are never recommended to increase phosphorus levels.

 

REF:   p. 167

 

  1. Magnesium plays a major role in blood pressure regulation. The strongest benefit occurs when magnesium is obtained from supplements.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Magnesium is vital to the structural integrity of heart muscle and plays a major role in blood pressure regulation. It is also vital to other muscles and nerves. The strongest benefit of magnesium is derived from foods rather than supplements.

 

REF:   p. 168

 

  1. Magnesium is the third most prevalent mineral in teeth. Enamel contains about three times more magnesium that dentin.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  C

Dentin contains about two times the amount of magnesium as does enamel.

 

REF:   p. 168

 

  1. Magnesium supplements are frequently recommended by dietitians because it is difficult to get enough magnesium from food alone.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  E

Excessive amounts of magnesium can be obtained from supplements. For this reason, supplements are reserved for patients with specific diseases or under stressful conditions. Note that decreased food intake, impaired magnesium absorption, and the use of certain diuretics may be situations in which magnesium supplements are advised.

 

REF:   p. 168

 

  1. Magnesium toxicity has been associated with kidney failure because the kidneys regulate plasma magnesium levels.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

 

 

ANS:  A

Because kidneys regulate plasma magnesium levels, toxicity has been associated with kidney failure. Pertinent to kidney function, magnesium is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. All these functions rely on proper kidney function for processing and excretion of by-products.

 

REF:   p. 169

 

  1. Each of the following is true of fluoride except one. Which one is the exception?
a. Fluoride is a nutrient essential for health.
b. It has no known metabolic function.
c. Saliva contains varying amounts of fluoride.
d. The amount of fluoride ingested has little effect on salivary levels.

 

 

ANS:  A

In a strict nutritional sense, fluoride is not a nutrient essential for health. Although present in low concentrations, in soft tissues, fluoride does not have any known metabolic function. Saliva contains varying amounts of fluoride; the amount of fluoride ingested has little effect on salivary levels.

 

REF:   p. 170

 

  1. Fluoride is advantageous to dental health because of its systemic effects before tooth eruption and both systemic and topical effects after toot eruption.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. neither the statement nor the reason is correct.

 

 

ANS:  C

After eruption, fluoride provides only topical effects. Systemic effects occur only before tooth eruption. The caries-preventive properties of systemic and topical fluoride are cumulative.

 

REF:   p. 170

 

  1. Each of the following characteristics of fluoride are true except one. Which one is the exception?
a. Fluoride stimulates osteoblast proliferation.
b. Fluoride increases new mineral deposition in cancellous bone.
c. It improves the density but not the strength of bone.
d. Fluoride decreases bone resorption.

 

 

ANS:  C

Fluoride improves both the density and strength of bone. By stimulating cells that form bone (osteoblasts), fluoride increases new mineral deposition in cancellous bone, improves the strength of bone, and decreases both bone resorption and bone solubility.

 

REF:   p. 170

 

  1. Each of the following is true of requirements and recommendations for fluoride utilization except one. Which one is the exception?
a. Adequate intake for all women is 3 mg/day.
b. Adequate intake for all men is 4 mg/day.
c. Average intake in the United States is 0.9 mg/day in areas without fluoridation.
d. The tolerable upper intake level for individuals over 9 years is 15 mg/day.

 

 

ANS:  D

The tolerable upper intake level for individuals over 9 years of age is 10 mg. Note that absorption of fluoride from sodium fluoride in water is estimated to be 80% to 90%. Children retain a larger percentage of fluoride in developing bones and teeth, whereas adults retain less in calcified structures.

 

REF:   p. 171

 

  1. Phytochemicals, which are natural components of foods, are thought to decrease bone mineral density (BMD) by inhibiting remodeling of bone. Caffeine has a negative effect on BMD because it increases calcium excretion.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  B

Phytochemicals, which are natural food components found in soy products and flaxseed, stimulate estrogen secretion, which can boost BMD. Bone remodeling, the increase in new bone by osteoblasts and breakdown of older bone by osteoclasts, is an ongoing dynamic process that maintains bone strength and density.

 

REF:   p. 175

 

  1. Fluoride ions can replace hydroxyl ions in the hydroxyapatite crystal lattice of teeth. This fluoridated hydroxyapatite, or fluorapatite, is more soluble and makes the tooth less resistant to demineralization.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

 

 

ANS:  D

Fluorapatite, the fluoridated hydroxyapatite is a less soluble structure that makes teeth more resistant to demineralizing acids. Additionally, fluorapatite enhances remineralization when a tooth is subject to the caries process. When small pits develop in the enamel, fluoride is believed to promote deposition of calcium phosphate to remineralize the enamel surface.

 

REF:   p. 170

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