Explain The Relationship Between Salt Intake And Drink More Water
Chapter 8 – Water and Minerals Chapter Learning Objectives
8.1 Describe the body’s water sources and routes of water loss, and name factors that influence the need for water.
8.2 Compare and contrast the health effects of various sources of fluid.
8.3 Discuss why electrolyte balance is critical for the health of the body.
8.4 Identify the major minerals important in human nutrition and their physiological roles in the body, the consequences of deficiencies, and their most important food sources.
8.5 Identify the trace minerals important in human nutrition and their physiological roles in the body, the consequences of deficiencies, and their most important food sources.
8.6 Outline a plan for obtaining sufficient calcium from a day’s meals. …show more content…
8.7 Describe the influence of diet during youth on the risk of osteoporosis later in life.
True/False Items
1. Anyone who eats a meal high in salt can temporarily increase his or her body’s water content.
2. After about 25 years of age, regardless of calcium intake, bones begin to lose density.
3. A deficiency of sodium is not harmful.
4. High salt intakes have been linked with high rates of stomach cancer.
5. The bioavailability of calcium in calcium-fortified orange juice is comparable to that of milk.
6. The body will signal thirst before dehydration occurs to prevent problems with fluid loss.
7. Soft water contains sodium, which may aggravate hypertension.
8. Some minerals act as buffers to help maintain body fluids at the correct pH to permit life’s processes.
9. The main source of iodine in the U.S. is plants grown in the middle part of the country.
10. The primary role of fluoride is to prevent dental caries throughout life.
Controversy 8 True/False Items
11. Whether a person develops osteoporosis seems to depend partly on heredity and partly on the environment, including nutrition.
12. Authorities recommend foods as a source of calcium in preference to calcium supplements.
Comprehension-Level Multiple-Choice Items
1. Which of the following makes up about 60 percent of the body’s weight?
a. major minerals
b. protein
c. water
d. trace minerals
2. Which of the following is not characteristic of water?
a. Its molecules resist being crowded together.
b. It dissolves amino acids, glucose, and minerals.
c. It is truly a universal solvent.
d. It acts as a lubricant around joints.
3. Water assists in:
a. temperature regulation.
b. shock protection.
c. acid-base regulation.
d. a and b
e. b and c
4. The first sign of dehydration is:
a. headache.
b. confusion.
c. thirst.
d. fatigue.
5. Water intake is governed by:
a. thirst.
b. sodium intake.
c. satiety.
d. a and c
e. b and c
6. Water excretion is regulated by the:
a. brain.
b. kidneys.
c. stomach.
d. a and b
e. b and c
7. Which of the following is the most accurate statement about the body’s need for water?
a. The reference man and woman both need equal amounts of fluid intake.
b. All water must come from beverages because foods don’t contain enough to contribute to intake.
c. Fluid needs for an individual person are the same every day.
d. Too much plain water consumption can cause a dangerous condition known as water intoxication.
8. The recommended source of fluid for healthy U.S. adults is:
a. plain drinking water, because it is safe and noncaloric.
b. carbonated beverages, because they have good flavor.
c. tea or coffee, because caffeine helps maintain fluid in the body.
d. fruit juice, because it has additional nutrients we need.
9. Hard water has high concentrations of:
a. sodium.
b. calcium.
c. magnesium.
d. a and b
e. b and c
10. Which of the following foods has the lowest percentage of water?
a. Chinese cabbage
b. fresh apple
c. margarine
d. lean steak
11. Which of the following agencies is responsible for ensuring that public water systems meet minimum standards for protection of public health?
a. Food and Drug Administration
b. Environmental Protection Agency
c. Food Safety and Inspection Service
d. World Health Organization
12. Which of the following is true about groundwater as a drinking water supply?
a. It comes from deep, protected underground aquifers.
b. It is protected from new contaminants.
c. Contaminants break down very quickly underground.
d. Fast movement and aeration help keep it clean.
13. Which of the following would you look for on the label of bottled water to signify safety?
a. “contains groundwater”
b. a statement that the source of the water is a spring in your state
c. “mountain spring water”
d. “contains filtered water”
14. Which of the following best describes the fluoride content of bottled water?
a. high
b. low
c. moderate
d. rare
15. Which of the following helps prevent changes in the acid-base balance of body fluids?
a. proteins
b. vitamins
c. mineral salts
d. a and c
e. b and c
16. Which of the following is the most abundant mineral in the body?
a. calcium
b. phosphorus
c. sodium
d. iron
17. Calcium in the body’s fluids performs all of the following major roles except:
a. regulating the transport of ions across cell membranes.
b. helping maintain normal blood glucose.
c. participating in blood clotting.
d. facilitating muscle contraction.
18. A person’s absorption of calcium varies based on:
a. age.
b. habitual intakes.
c. gender.
d. a and b
e. b and c
19. Breast-fed infants absorb about _____ percent of ingested calcium.
a. 10
b. 30
c. 40
d. 60
20. For women and men in the 19- to 50-year-old range, the calcium DRI is _____ milligrams.
a. 600
b. 800
c. 1000
d. 1200
21. The best source of phosphorus is:
a. animal protein.
b. fruit.
c. vegetable protein.
d. grain products.
22. Over half of the body’s magnesium is stored in the:
a. teeth.
b. liver.
c. bones.
d. blood.
23. The chief ion used to maintain the volume of fluid outside cells is:
a. potassium.
b. chloride.
c. sodium.
d. calcium.
24. Adults in the United States consume an average of _____ milligrams per day of sodium.
a. 500
b. 1200
c. 2400
d. 3400
25. The more processed a food:
a. the more sodium it contains.
b. the more potassium it contains.
c. the less sodium it contains.
d. the more calcium it contains.
26. Which of the following is the principal positively charged ion inside body cells?
a. calcium
b. sodium
c. magnesium
d. potassium
27. The principal food source of chloride is:
a. salt.
b. animal products.
c. plants.
d. grains.
28. Sulfate is adequate in a diet that contains sufficient:
a. fat.
b. protein.
c. carbohydrate.
d. vitamins.
29. Which of the following must be available for thyroxine to be synthesized?
a. iron
b. iodine
c. zinc
d. fluoride
30. Which of the following impairs iron absorption?
a. tea
b. phytates
c. vitamin C
d. a and b
e. b and c
31. The DRI iron intake recommendation is 8 mg/day for:
a. women 19-50 years of age.
b. men.
c. women 51 years or older.
d. a and b
e. b and c
32. Which of the following foods provides the highest amount of zinc?
a. legumes
b. whole-grain bread
c. shellfish
d. spinach
33. Which of the following foods provides the least amount of available zinc?
a. meats
b. poultry
c. legumes
d. shellfish
34. Low blood selenium correlates with development of:
a. chronic fatigue.
b. prostate cancer.
c. poor immunity.
d. lung cancer.
35. Which of the following stabilizes bones and makes teeth resistant to decay?
a. chromium
b. chloride
c. fluoride
d. zinc
36. A zinc toxicity reduces _____.
a. iron absorption
b. LDL cholesterol
c. insulin response
d. bone density
37. Chromium works closely with:
a. insulin.
b. collagen.
c. hemoglobin.
d. enzymes.
38. The best way to obtain the calcium you need is to:
a. consume more spinach, rhubarb, and Swiss chard.
b. eat more cottage cheese and frozen yogurt.
c. consume more milk, cheese, and yogurt.
d. consume more cream cheese, butter, and cream.
Application-Level Multiple-Choice Items
39. Which characteristic of water allows it to act as a lubricant?
a. ability to dissolve substances
b. incompressibility
c. heat-holding capacity
d. a and b
e. b and c
40. During physical activity the body will cool down by:
a. sweating to carry heat away from the surface of the body.
b. increasing urination to carry heat away through the kidneys.
c. drawing the blood away from the surface of the skin to let the body core cool it.
d. using the water from metabolism to cool the body core.
41. When you eat pizza, the body will respond to the high sodium intake in the ingredients by:
a. controlling water movement tightly to prevent any fluctuations in body weight.
b. turning off the thirst signal to reduce additional intake of fluids.
c. signaling the kidneys to immediately begin removing fluid from the body.
d. shifting water back into the bloodstream to reduce the sodium concentration.
42. When your body gives the thirst signal it is important to:
a. consider drinking fluids in the near future to prevent dehydration.
b. ignore the signal because you just had a large glass of water.
c. drink fluids to relieve the symptoms of dehydration.
d. drink large volumes of plain water to prevent water intoxication.
43. How much water or other beverages (in cups) should a man consume each day, under moderate environmental conditions and given a normal diet?
a. 6
b. 9
c. 13
d. 15
44. What is the best beverage choice?
a. sport drinks because they replace important minerals missing from the diet
b. hard water because it has a high concentration of calcium and magnesium
c. soft water because it replaces sodium that is lost from the body
d. fruit juices because they naturally contain vitamins and minerals
45. Which is the most accurate statement about beverage consumption practices in the U.S.?
a. The average calorie intake from beverages among U.S. adults increases with age.
b. Vegetable juices are a concern because their intake adds a significant amount of discretionary calories.
c. The mild diuretic effect of a moderate intake of caffeinated beverages does not prevent people from meeting fluid needs.
d. Because artificially sweetened carbonated beverages are chosen most often, beverages do not crowd more nutritious foods out of the diet.
46. A friend informs you that she is planning to purchase a water softener. Which of the following statements would be most appropriate for you to make to your friend?
a. Hard water makes more bubbles with less soap than soft water and is more desirable.
b. Soft water leaves a ring in the tub and a gray residue in the wash, which are undesirable.
c. Soft water appears to aggravate hypertension and heart disease, which is undesirable.
d. Soft water has higher concentrations of calcium and magnesium than hard water, which is desirable.
47. Water chlorination is important because:
a. it has no effect on many harmful microorganisms found in water.
b. it has been documented to cause cancer in people who drink it regularly.
c. alternative treatment systems for water are much less expensive and faster to use.
d. deaths from organisms in untreated water are high in other parts of the world.
48. Jennifer says she drinks bottled water because it is safer than tap water. You tell her that bottled water:
a. has been withdrawn from an underwater spring and is naturally pure.
b. has been filtered by the manufacturer to remove contaminants.
c. all tastes exactly the same as tap water.
d. may be treated tap water.
49. When a child has a virus that has caused vomiting and diarrhea over several days’ time it is critical for her to receive medical care because:
a. her fever will cause her to retain too much extra fluid.
b. she may need help in replacing extreme fluid losses.
c. in the cells, sodium concentration increases, leading to danger of swelling.
d. her kidneys will pump extra fluids into the bloodstream.
50. It is critical for body cells to maintain fluid and electrolyte balance by:
a. increasing intake of sodium when a person becomes dehydrated.
b. allowing minerals to slip freely across the cell membranes.
c. attracting water into the cell through increased electrolyte concentrations.
d. keeping the majority of water outside the cells.
51. Which of the following statements is true?
a. People develop their peak bone mass during the first four decades of life.
b. The skeleton no longer adds to bone density after 20 years of age.
c. The bones begin to lose density after 40 years of age regardless of calcium intake.
d. People do not need calcium throughout life.
52. If a person has a deficient dietary intake of calcium, what will be the result?
a. a reduced rate of calcium absorption
b. no change in levels of calcium in the blood because calcium will be pulled from the bones
c. a gain of body weight
d. lowered levels of calcium in the blood because of the deficiency
53. Which of the following people will likely absorb the least amount of calcium?
a. A 42-year-old man
b. A 3-year-old girl
c. A 4-month-old boy
d. A 21-year-old pregnant women
54. Phosphorus is critical to the acid-base balance in cells because of its role in:
a. creating buffers to maintain the correct pH.
b. creating phospholipids to carry fats through the blood.
c. binding with calcium in muscle tissues.
d. transporting sodium from the cells.
55. Magnesium is an important mineral that works with calcium in the body to:
a. increase bone density.
b. maintain acid-base balance in the cells.
c. control blood glucose levels.
d. help muscles contract and relax.
56. How much sodium is consumed by a person who eats two grams of salt?
a. 400 mg
b. 800 mg
c. 1000 mg
d. 1200 mg
57. A person is consuming 1000 mg a day of sodium preservatives in processed foods along with 2000 milligrams of added salt from the salt shaker on his foods. Is this less than the UL for sodium established by the DRI committee?
a. no, 3000 total milligrams of sodium exceeds the UL
b. yes, 3000 total milligrams of sodium is within the UL
c. no, 1800 total milligrams of sodium exceeds the UL
d. yes, 1800 total milligrams of sodium is within the UL
58. The DASH diet is more effective in reducing blood pressure than just decreasing sodium alone because it includes which of the following guidelines?
a. reduce the intake of dairy products
b. add moderate amounts of salt to prepared foods
c. greatly increase intakes of fruits and vegetables
d. eliminate grain products from the diet
59. Which of the following would you consume with a food source of iron in order to facilitate iron absorption?
a. tea and a soy protein hamburger
b. tomato and meat, fish, or poultry
c. coffee and wheat bran muffins
d. calcium supplement and whole-wheat bread
60. When trying to consume adequate dietary iron it is helpful to:
a. eat non-heme iron found only in plants because it is absorbed more efficiently.
b. consider adding supplements because they are better absorbed than iron in foods.
c. combine vitamin C-rich foods with non-heme iron sources to increase absorption.
d. avoid combining heme-iron foods with non-heme-iron foods in the same meal.
61. Do high intakes of iron from foods pose a danger to healthy people?
a. yes, if they include large amounts of fortified grains and cereals
b. no, because the body adjusts the amount of iron absorbed
c. yes, because of high intakes of vitamin C supplements among many people
d. no, because non-heme iron blocks the absorption of heme iron
62. Your best friend complains that she is tired all of the time and has a problem concentrating. In addition, she likes to chew ice. Which of the following is your friend likely to have?
a. potassium deficiency
b. zinc deficiency
c. magnesium deficiency
d. iron deficiency
63. What effect does zinc deficiency have on the body?
a. a minor effect because zinc has only a limited role in the body
b. impairs the immune response, leading to increased infections
c. increases metabolism and increases appetite, leading to weight gain
d. reduces iron absorption because iron needs zinc for transport
64. You are working with a child in a health clinic who has growth retardation, impaired immunity, and a poor appetite. This child is most likely experiencing _____ deficiency.
a. iron
b. chromium
c. zinc
d. magnesium
65. Which of the following statements about selenium levels in the body is accurate?
a. men with high blood levels of selenium from taking supplements have decreased cancer risk
b. selenium works as an antioxidant to protect body chemicals from oxidative damage
c. there is no danger of toxicity when taking selenium supplements
d. it is difficult to obtain enough selenium from foods in the diet
66. What is currently known about fluoride in drinking water supplies?
a. All bottled water contains fluoride added as part of the bottling process.
b. Scientific evidence has shown that communities with fluoridated water have higher cancer rates.
c. Very few communities in the U.S. have fluoridated water.
d. In communities where fluoride is lacking in the water there is a very high dental decay rate.
67. What would you tell someone who is considering taking chromium supplements? a Chromium supplements help prevent diabetes in people at risk for developing it.
b. Chromium supplements have been shown to increase muscle mass in athletes.
c. No benefit for reducing body fat with chromium supplements has been proven.
d. There is an increased risk of developing cancer with chromium supplementation.
68. Copper is an essential nutrient because of its role in:
a. forming hemoglobin and collagen.
b. increasing free radical activity.
c. regulating zinc absorption.
d. regulating blood glucose.
69. Which of the following would be the best selection to provide good sources of calcium in the diet?
a. milk, yogurt, and ice milk
b. kefir, butter, and cottage cheese
c. buttermilk, cream cheese, and almonds
d. cheese, cream, and broccoli
Controversy 8 Multiple-Choice Items
70. One of the health concerns with osteoporosis is that:
a. it is a condition that begins developing in the elderly.
b. it affects mainly the cortical bone.
c. it causes hip fractures that fragment into small pieces.
d. it affects only men.
71. The strongest genetic influence on the development of osteoporosis is:
a. the maximum bone mass that can be attained during growth.
b. its influence over the absorption rate of vitamin A.
c. its influence over the amount of bone lost in early adulthood.
d. its effect on estrogen production in young women.
72. Which of the following ethnic groups has the lowest risk for osteoporosis?
a. Asians
b. Hispanics
c. Caucasians
d. Africans
73. Calcium absorption declines in the elderly because:
a. older people tend to lose lean body mass.
b. aging skin is less efficient at making vitamin D.
c. many elderly people get inadequate sun exposure.
d. a and b
e. b and c
74. Osteoporosis is most often associated with:
a. heavier body weights.
b. underweight.
c. higher body fatness.
d. exercise.
75. Bone strength in later life depends on:
a. the increased calcium absorption in the elderly.
b. the increased production of estrogen after menopause.
c. reducing physical activity to protect bones.
d. the formation of dense bones during youth.
76. A young woman wanting to build maximum bone density should do all of the following except:
a. reduce her intake of protein.
b. reduce her sodium intake.
c. limit her intake of regular cola drinks.
d. participate in regular weight-bearing exercise.
77. Which of the following is an accurate statement about calcium supplements for bone health?
a. It is difficult for young women to get enough dietary calcium, so they need a supplement.
b. Calcium-fortified soy milk provides an easily absorbed form of calcium.
c. Calcium supplements are absorbed more readily than calcium in milk.
d. There are no toxicity concerns with taking large amounts of calcium in supplement form.
Use the calcium supplements label to answer questions 78-82.
Suggested use: As a dietary supplement, take two (2) gummy vitamins per day.
Supplement Facts
Serving Size 2 gummy vitamins
Servings Per Bottle 30
Calories 25
Amount Per Serving
% Daily Value*
Total Carbohydrate
6 g
2%
Sugars
5 g
**
Vitamin D
(as cholecalciferol)
1000 IU
250%
Calcium (as tricalcium phosphate)
500 mg
50%
Phosphorus (as tricalcium phosphate)
200 mg
20%
Sodium
15 mg
<1%
* Percent Daily Values are based on a 2,000 calorie diet.
**Daily Value not established.
Other ingredients: Sucrose, glucose syrup, gelatin, pectin, natural flavors, citric acid, lactic acid and colors (black carrot juice extract, annatto extract, carrot and blueberry juices).
This product contains natural colors and flavors. Contains no wheat (gluten), milk, eggs, peanuts, tree nuts or soy.
78. This supplement uses tricalcium phosphate as its source of calcium. What can you state about how well that form is absorbed?
a. It is not absorbed well because of contaminants.
b. It is a form that is absorbed equally well as other forms.
c. It is a form that can accelerate calcium losses from the body.
d. It is absorbed too quickly and may lead to toxic levels.
79. What can you say about the chewable “gummy” form of this supplement?
a. This may interfere with absorption because it has to be chewed.
b. It may be more difficult to swallow.
c. It may enhance the action of stomach acid on the supplement.
d. There are ingredients in the product that interfere with calcium absorption.
80. The amount of calcium in one dose of this supplement:
a. is potentially toxic and should be avoided.
b. is a typical dose found in most calcium supplements.
c. is too low to provide any benefit.
d. can help with magnesium absorption in the body.
81. The vitamin D included in this supplement has what effect?
a. limits the absorption of calcium
b. may increase the risk of fractures
c. can cause toxicity if combined with other vitamin D sources in the diet
d. has no effect on the calcium in the supplement
82. If an individual with diabetes plans to take this supplement, what would be the recommendation?
a. Avoid this supplement because it has a high sugar content.
b. Don’t worry—the amount of carbohydrate in a dose is very low.
c. Because the carbohydrate is in a mineral supplement, it poses no concern.
d. Count the carbohydrate content of the supplement as part of total daily intake.
Essay Items
1.
Identify and explain factors involved in governing water intake and water excretion.
2. Would you discourage someone from purchasing a water softener? Provide a rationale for your answer.
3. What is peak bone mass and when is it developed?
4. Explain the rationale for the following statement: “The way to keep body salt and water weight under control is to control salt intake and drink more, not less, water.”
5. Describe the relationship between salt intake and blood pressure. Who is at greatest risk for adverse effects from excessive sodium intakes?
6. Describe the characteristics of DASH (Dietary Approaches to Stop Hypertension).
7. Differentiate between iron deficiency and iron-deficiency anemia and describe the causes and symptoms of the latter.
8. Explain the rationale for the argument against high-level iron fortification in foods.
9. Describe what is known about the relationship between a protein intakes and bone health.
10. Why do nutrition authorities recommend foods as the source of calcium rather than supplements?
Answer Key (ANS = answer, REF = page reference, DIF = difficulty, OBJ = learning objective)
True/False Items
1. ANS: T REF: 289 DIF: Comprehension-level OBJ: 8.1
2. ANS: F REF: 301 DIF: Comprehension-level OBJ:
8.4
3. ANS: F REF: 305 DIF: Comprehension-level OBJ: 8.4
4. ANS: T REF: 307 DIF: Comprehension-level OBJ: 8.4
5. ANS: T REF: 325 DIF: Comprehension-level OBJ: 8.6
6. ANS: F REF: 290 DIF: Comprehension-level OBJ: 8.1
7. ANS: T REF: 295 DIF: Comprehension-level OBJ: 8.2
8. ANS: T REF: 298-299 DIF: Comprehension-level OBJ: 8.3
9. ANS: F REF: 311 DIF: Comprehension-level OBJ: 8.5
10. ANS: T REF: 319 DIF: Comprehension-level OBJ: 8.5
11. ANS: T REF: 329 DIF: Comprehension-level OBJ: 8.7
12. ANS: T REF: 332 DIF: Comprehension-level OBJ: 8.7
Multiple-Choice Items
1. ANS: c REF: 288 DIF: Comprehension-level OBJ: 8.1
2. ANS: c REF: 288-289 DIF: Comprehension-level OBJ: 8.1
3. ANS: d REF: 288-289 DIF: Comprehension-level OBJ: 8.1
4. ANS: c REF: 290 DIF: Comprehension-level OBJ: 8.1
5. ANS: d REF: 290 DIF: Comprehension-level OBJ: 8.1
6. ANS: d REF: 290 DIF: Comprehension-level OBJ: 8.1
7. ANS: d REF: 291-292 DIF: Comprehension-level OBJ: 8.1
8. ANS: a REF: 294|295 DIF: Comprehension-level OBJ: 8.2
9. ANS: e REF: 294 DIF: Comprehension-level OBJ: 8.2
10. ANS: c REF: 292 DIF: Comprehension-level OBJ: 8.1
11. ANS: b REF: 295 DIF: Comprehension-level OBJ: 8.2
12. ANS: a REF: 296 DIF: Comprehension-level OBJ: 8.2
13. ANS: d REF: 296 DIF: Comprehension-level OBJ: 8.2
14. ANS: d REF: 320 DIF: Comprehension-level OBJ: 8.5
15. ANS: d REF: 298 DIF: Comprehension-level OBJ: 8.3
16. ANS: a REF: 299 DIF: Comprehension-level OBJ: 8.4
17. ANS: b REF: 299 DIF: Comprehension-level OBJ: 8.4
18. ANS: d REF: 300-301 DIF: Comprehension-level OBJ: 8.4
19. ANS: d REF: 300 DIF: Comprehension-level OBJ: 8.4
20. ANS: c REF: 302 DIF: Comprehension-level OBJ: 8.4
21. ANS: a REF: 302 DIF: Comprehension-level OBJ: 8.4
22. ANS: c REF: 303 DIF: Comprehension-level OBJ: 8.4
23. ANS: c REF: 304 DIF: Comprehension-level OBJ: 8.4
24. ANS: d REF: 306 DIF: Comprehension-level OBJ: 8.4
25. ANS: a REF: 307 DIF: Comprehension-level OBJ: 8.4
26. ANS: d REF: 308 DIF: Comprehension-level OBJ: 8.4
27. ANS: a REF: 310 DIF: Comprehension-level OBJ: 8.4
28. ANS: b REF: 323 DIF: Comprehension-level OBJ: 8.4
29. ANS: b REF: 310 DIF: Comprehension-level OBJ: 8.5
30. ANS: d REF: 313 DIF: Comprehension-level OBJ: 8.5
31. ANS: e REF: 316 DIF: Comprehension-level OBJ: 8.5
32. ANS: c REF: 318 DIF: Comprehension-level OBJ: 8.5
33. ANS: c REF: 318 DIF: Comprehension-level OBJ: 8.5
34. ANS: b REF: 319 DIF: Comprehension-level OBJ: 8.5
35. ANS: c REF: 319-320 DIF: Comprehension-level OBJ: 8.5
36. ANS: a REF: 318 DIF: Comprehension-level OBJ: 8.5
37. ANS: a REF: 320 DIF: Comprehension-level OBJ: 8.5
38. ANS: c REF: 324 DIF: Comprehension-level OBJ: 8.6
39. ANS: b REF: 289 DIF: Application-level OBJ: 8.1
40. ANS: a REF: 289 DIF: Application-level OBJ: 8.1
41. ANS: d REF: 289|305 DIF: Application-level OBJ: 8.1|8.4
42. ANS: c REF: 290 DIF: Application-level OBJ: 8.1
43. ANS: c REF: 291 DIF: Application-level OBJ: 8.1
44. ANS: b REF: 294-295 DIF: Application-level OBJ: 8.2
45. ANS: c REF: 291|293-294 DIF: Application-level OBJ: 8.1|8.2
46. ANS: c REF: 294-295 DIF: Application-level OBJ: 8.2
47. ANS: d REF: 295 DIF: Application-level OBJ: 8.2
48. ANS: d REF: 296 DIF: Application-level OBJ: 8.2
49. ANS: b REF: 298 DIF: Application-level OBJ: 8.3
50. ANS: c REF: 297-298 DIF: Application-level OBJ: 8.3
51. ANS: c REF: 301 DIF: Application-level OBJ: 8.4
52. ANS: b REF: 300 DIF: Application-level OBJ: 8.4
53. ANS: a REF: 300 DIF: Application-level OBJ: 8.4
54. ANS: a REF: 302 DIF: Application-level OBJ: 8.4
55. ANS: d REF: 304 DIF: Application-level OBJ: 8.4
56. ANS: b REF: 304 DIF: Application-level OBJ: 8.4
57. ANS: d REF: 304|306 DIF: Application-level OBJ: 8.4
58. ANS: c REF: 306 DIF: Application-level OBJ: 8.4
59. ANS: b REF: 313 DIF: Application-level OBJ: 8.5
60. ANS: c REF: 313 DIF: Application-level OBJ: 8.5
61. ANS: b REF: 316 DIF: Application-level OBJ: 8.5
62. ANS: d REF: 314 DIF: Application-level OBJ: 8.5
63. ANS: b REF: 317 DIF: Application-level OBJ: 8.5
64. ANS: c REF: 317 DIF: Application-level OBJ: 8.5
65. ANS: b REF: 319 DIF: Application-level OBJ: 8.5
66. ANS: d REF: 320 DIF: Application-level OBJ: 8.5
67. ANS: c REF: 320 DIF: Application-level OBJ: 8.5
68. ANS: a REF: 321 DIF: Application-level OBJ: 8.5
69. ANS: a REF: 324 DIF: Application-level OBJ: 8.6
70. ANS: c REF: 328 DIF: Comprehension-level OBJ: 8.7
71. ANS: a REF: 329 DIF: Comprehension-level OBJ: 8.7
72. ANS: d REF: 329|330 DIF: Comprehension-level OBJ: 8.7
73. ANS: e REF: 329 DIF: Comprehension-level OBJ: 8.7
74. ANS: b REF: 330 DIF: Comprehension-level OBJ: 8.7
75. ANS: d REF: 329 DIF: Comprehension-level OBJ: 8.7
76. ANS: a REF: 330-331 DIF: Application-level OBJ: 8.7
77. ANS: b REF: 332-333 DIF: Comprehension-level OBJ: 8.7
78. ANS: b REF: 333 DIF: Application-level OBJ: 8.7
79. ANS: c REF: 333 DIF: Application-level OBJ: 8.7
80. ANS: b REF: 333 DIF: Application-level OBJ: 8.7
81. ANS: c REF: 332|333 DIF: Application-level OBJ: 8.7
82. ANS: d REF: 332|333 DIF: Application-level OBJ: 8.7
Essay Items
1. REF: 289-292 DIF: Comprehension-level OBJ: 8.1
2. REF: 294-295 DIF: Application-level OBJ: 8.2
3. REF: 301 DIF: Comprehension-level OBJ: 8.4
4. REF: 305 DIF: Application-level OBJ: 8.4
5. REF: 305-307 DIF: Comprehension-level OBJ: 8.4
6. REF: 306-307 DIF: Comprehension-level OBJ: 8.4
7. REF: 313-315 DIF: Comprehension-level OBJ: 8.5
8. REF: 316 DIF: Application-level OBJ: 8.5
9. REF: 331 DIF: Comprehension-level OBJ: 8.7
10. REF: 332-333 DIF: Application-level OBJ: 8.7
8.1 Describe the body’s water sources and routes of water loss, and name factors that influence the need for water.
8.2 Compare and contrast the health effects of various sources of fluid.
8.3 Discuss why electrolyte balance is critical for the health of the body.
8.4 Identify the major minerals important in human nutrition and their physiological roles in the body, the consequences of deficiencies, and their most important food sources.
8.5 Identify the trace minerals important in human nutrition and their physiological roles in the body, the consequences of deficiencies, and their most important food sources.
8.6 Outline a plan for obtaining sufficient calcium from a day’s meals. …show more content…
8.7 Describe the influence of diet during youth on the risk of osteoporosis later in life.
True/False Items
1. Anyone who eats a meal high in salt can temporarily increase his or her body’s water content.
2. After about 25 years of age, regardless of calcium intake, bones begin to lose density.
3. A deficiency of sodium is not harmful.
4. High salt intakes have been linked with high rates of stomach cancer.
5. The bioavailability of calcium in calcium-fortified orange juice is comparable to that of milk.
6. The body will signal thirst before dehydration occurs to prevent problems with fluid loss.
7. Soft water contains sodium, which may aggravate hypertension.
8. Some minerals act as buffers to help maintain body fluids at the correct pH to permit life’s processes.
9. The main source of iodine in the U.S. is plants grown in the middle part of the country.
10. The primary role of fluoride is to prevent dental caries throughout life.
Controversy 8 True/False Items
11. Whether a person develops osteoporosis seems to depend partly on heredity and partly on the environment, including nutrition.
12. Authorities recommend foods as a source of calcium in preference to calcium supplements.
Comprehension-Level Multiple-Choice Items
1. Which of the following makes up about 60 percent of the body’s weight?
a. major minerals
b. protein
c. water
d. trace minerals
2. Which of the following is not characteristic of water?
a. Its molecules resist being crowded together.
b. It dissolves amino acids, glucose, and minerals.
c. It is truly a universal solvent.
d. It acts as a lubricant around joints.
3. Water assists in:
a. temperature regulation.
b. shock protection.
c. acid-base regulation.
d. a and b
e. b and c
4. The first sign of dehydration is:
a. headache.
b. confusion.
c. thirst.
d. fatigue.
5. Water intake is governed by:
a. thirst.
b. sodium intake.
c. satiety.
d. a and c
e. b and c
6. Water excretion is regulated by the:
a. brain.
b. kidneys.
c. stomach.
d. a and b
e. b and c
7. Which of the following is the most accurate statement about the body’s need for water?
a. The reference man and woman both need equal amounts of fluid intake.
b. All water must come from beverages because foods don’t contain enough to contribute to intake.
c. Fluid needs for an individual person are the same every day.
d. Too much plain water consumption can cause a dangerous condition known as water intoxication.
8. The recommended source of fluid for healthy U.S. adults is:
a. plain drinking water, because it is safe and noncaloric.
b. carbonated beverages, because they have good flavor.
c. tea or coffee, because caffeine helps maintain fluid in the body.
d. fruit juice, because it has additional nutrients we need.
9. Hard water has high concentrations of:
a. sodium.
b. calcium.
c. magnesium.
d. a and b
e. b and c
10. Which of the following foods has the lowest percentage of water?
a. Chinese cabbage
b. fresh apple
c. margarine
d. lean steak
11. Which of the following agencies is responsible for ensuring that public water systems meet minimum standards for protection of public health?
a. Food and Drug Administration
b. Environmental Protection Agency
c. Food Safety and Inspection Service
d. World Health Organization
12. Which of the following is true about groundwater as a drinking water supply?
a. It comes from deep, protected underground aquifers.
b. It is protected from new contaminants.
c. Contaminants break down very quickly underground.
d. Fast movement and aeration help keep it clean.
13. Which of the following would you look for on the label of bottled water to signify safety?
a. “contains groundwater”
b. a statement that the source of the water is a spring in your state
c. “mountain spring water”
d. “contains filtered water”
14. Which of the following best describes the fluoride content of bottled water?
a. high
b. low
c. moderate
d. rare
15. Which of the following helps prevent changes in the acid-base balance of body fluids?
a. proteins
b. vitamins
c. mineral salts
d. a and c
e. b and c
16. Which of the following is the most abundant mineral in the body?
a. calcium
b. phosphorus
c. sodium
d. iron
17. Calcium in the body’s fluids performs all of the following major roles except:
a. regulating the transport of ions across cell membranes.
b. helping maintain normal blood glucose.
c. participating in blood clotting.
d. facilitating muscle contraction.
18. A person’s absorption of calcium varies based on:
a. age.
b. habitual intakes.
c. gender.
d. a and b
e. b and c
19. Breast-fed infants absorb about _____ percent of ingested calcium.
a. 10
b. 30
c. 40
d. 60
20. For women and men in the 19- to 50-year-old range, the calcium DRI is _____ milligrams.
a. 600
b. 800
c. 1000
d. 1200
21. The best source of phosphorus is:
a. animal protein.
b. fruit.
c. vegetable protein.
d. grain products.
22. Over half of the body’s magnesium is stored in the:
a. teeth.
b. liver.
c. bones.
d. blood.
23. The chief ion used to maintain the volume of fluid outside cells is:
a. potassium.
b. chloride.
c. sodium.
d. calcium.
24. Adults in the United States consume an average of _____ milligrams per day of sodium.
a. 500
b. 1200
c. 2400
d. 3400
25. The more processed a food:
a. the more sodium it contains.
b. the more potassium it contains.
c. the less sodium it contains.
d. the more calcium it contains.
26. Which of the following is the principal positively charged ion inside body cells?
a. calcium
b. sodium
c. magnesium
d. potassium
27. The principal food source of chloride is:
a. salt.
b. animal products.
c. plants.
d. grains.
28. Sulfate is adequate in a diet that contains sufficient:
a. fat.
b. protein.
c. carbohydrate.
d. vitamins.
29. Which of the following must be available for thyroxine to be synthesized?
a. iron
b. iodine
c. zinc
d. fluoride
30. Which of the following impairs iron absorption?
a. tea
b. phytates
c. vitamin C
d. a and b
e. b and c
31. The DRI iron intake recommendation is 8 mg/day for:
a. women 19-50 years of age.
b. men.
c. women 51 years or older.
d. a and b
e. b and c
32. Which of the following foods provides the highest amount of zinc?
a. legumes
b. whole-grain bread
c. shellfish
d. spinach
33. Which of the following foods provides the least amount of available zinc?
a. meats
b. poultry
c. legumes
d. shellfish
34. Low blood selenium correlates with development of:
a. chronic fatigue.
b. prostate cancer.
c. poor immunity.
d. lung cancer.
35. Which of the following stabilizes bones and makes teeth resistant to decay?
a. chromium
b. chloride
c. fluoride
d. zinc
36. A zinc toxicity reduces _____.
a. iron absorption
b. LDL cholesterol
c. insulin response
d. bone density
37. Chromium works closely with:
a. insulin.
b. collagen.
c. hemoglobin.
d. enzymes.
38. The best way to obtain the calcium you need is to:
a. consume more spinach, rhubarb, and Swiss chard.
b. eat more cottage cheese and frozen yogurt.
c. consume more milk, cheese, and yogurt.
d. consume more cream cheese, butter, and cream.
Application-Level Multiple-Choice Items
39. Which characteristic of water allows it to act as a lubricant?
a. ability to dissolve substances
b. incompressibility
c. heat-holding capacity
d. a and b
e. b and c
40. During physical activity the body will cool down by:
a. sweating to carry heat away from the surface of the body.
b. increasing urination to carry heat away through the kidneys.
c. drawing the blood away from the surface of the skin to let the body core cool it.
d. using the water from metabolism to cool the body core.
41. When you eat pizza, the body will respond to the high sodium intake in the ingredients by:
a. controlling water movement tightly to prevent any fluctuations in body weight.
b. turning off the thirst signal to reduce additional intake of fluids.
c. signaling the kidneys to immediately begin removing fluid from the body.
d. shifting water back into the bloodstream to reduce the sodium concentration.
42. When your body gives the thirst signal it is important to:
a. consider drinking fluids in the near future to prevent dehydration.
b. ignore the signal because you just had a large glass of water.
c. drink fluids to relieve the symptoms of dehydration.
d. drink large volumes of plain water to prevent water intoxication.
43. How much water or other beverages (in cups) should a man consume each day, under moderate environmental conditions and given a normal diet?
a. 6
b. 9
c. 13
d. 15
44. What is the best beverage choice?
a. sport drinks because they replace important minerals missing from the diet
b. hard water because it has a high concentration of calcium and magnesium
c. soft water because it replaces sodium that is lost from the body
d. fruit juices because they naturally contain vitamins and minerals
45. Which is the most accurate statement about beverage consumption practices in the U.S.?
a. The average calorie intake from beverages among U.S. adults increases with age.
b. Vegetable juices are a concern because their intake adds a significant amount of discretionary calories.
c. The mild diuretic effect of a moderate intake of caffeinated beverages does not prevent people from meeting fluid needs.
d. Because artificially sweetened carbonated beverages are chosen most often, beverages do not crowd more nutritious foods out of the diet.
46. A friend informs you that she is planning to purchase a water softener. Which of the following statements would be most appropriate for you to make to your friend?
a. Hard water makes more bubbles with less soap than soft water and is more desirable.
b. Soft water leaves a ring in the tub and a gray residue in the wash, which are undesirable.
c. Soft water appears to aggravate hypertension and heart disease, which is undesirable.
d. Soft water has higher concentrations of calcium and magnesium than hard water, which is desirable.
47. Water chlorination is important because:
a. it has no effect on many harmful microorganisms found in water.
b. it has been documented to cause cancer in people who drink it regularly.
c. alternative treatment systems for water are much less expensive and faster to use.
d. deaths from organisms in untreated water are high in other parts of the world.
48. Jennifer says she drinks bottled water because it is safer than tap water. You tell her that bottled water:
a. has been withdrawn from an underwater spring and is naturally pure.
b. has been filtered by the manufacturer to remove contaminants.
c. all tastes exactly the same as tap water.
d. may be treated tap water.
49. When a child has a virus that has caused vomiting and diarrhea over several days’ time it is critical for her to receive medical care because:
a. her fever will cause her to retain too much extra fluid.
b. she may need help in replacing extreme fluid losses.
c. in the cells, sodium concentration increases, leading to danger of swelling.
d. her kidneys will pump extra fluids into the bloodstream.
50. It is critical for body cells to maintain fluid and electrolyte balance by:
a. increasing intake of sodium when a person becomes dehydrated.
b. allowing minerals to slip freely across the cell membranes.
c. attracting water into the cell through increased electrolyte concentrations.
d. keeping the majority of water outside the cells.
51. Which of the following statements is true?
a. People develop their peak bone mass during the first four decades of life.
b. The skeleton no longer adds to bone density after 20 years of age.
c. The bones begin to lose density after 40 years of age regardless of calcium intake.
d. People do not need calcium throughout life.
52. If a person has a deficient dietary intake of calcium, what will be the result?
a. a reduced rate of calcium absorption
b. no change in levels of calcium in the blood because calcium will be pulled from the bones
c. a gain of body weight
d. lowered levels of calcium in the blood because of the deficiency
53. Which of the following people will likely absorb the least amount of calcium?
a. A 42-year-old man
b. A 3-year-old girl
c. A 4-month-old boy
d. A 21-year-old pregnant women
54. Phosphorus is critical to the acid-base balance in cells because of its role in:
a. creating buffers to maintain the correct pH.
b. creating phospholipids to carry fats through the blood.
c. binding with calcium in muscle tissues.
d. transporting sodium from the cells.
55. Magnesium is an important mineral that works with calcium in the body to:
a. increase bone density.
b. maintain acid-base balance in the cells.
c. control blood glucose levels.
d. help muscles contract and relax.
56. How much sodium is consumed by a person who eats two grams of salt?
a. 400 mg
b. 800 mg
c. 1000 mg
d. 1200 mg
57. A person is consuming 1000 mg a day of sodium preservatives in processed foods along with 2000 milligrams of added salt from the salt shaker on his foods. Is this less than the UL for sodium established by the DRI committee?
a. no, 3000 total milligrams of sodium exceeds the UL
b. yes, 3000 total milligrams of sodium is within the UL
c. no, 1800 total milligrams of sodium exceeds the UL
d. yes, 1800 total milligrams of sodium is within the UL
58. The DASH diet is more effective in reducing blood pressure than just decreasing sodium alone because it includes which of the following guidelines?
a. reduce the intake of dairy products
b. add moderate amounts of salt to prepared foods
c. greatly increase intakes of fruits and vegetables
d. eliminate grain products from the diet
59. Which of the following would you consume with a food source of iron in order to facilitate iron absorption?
a. tea and a soy protein hamburger
b. tomato and meat, fish, or poultry
c. coffee and wheat bran muffins
d. calcium supplement and whole-wheat bread
60. When trying to consume adequate dietary iron it is helpful to:
a. eat non-heme iron found only in plants because it is absorbed more efficiently.
b. consider adding supplements because they are better absorbed than iron in foods.
c. combine vitamin C-rich foods with non-heme iron sources to increase absorption.
d. avoid combining heme-iron foods with non-heme-iron foods in the same meal.
61. Do high intakes of iron from foods pose a danger to healthy people?
a. yes, if they include large amounts of fortified grains and cereals
b. no, because the body adjusts the amount of iron absorbed
c. yes, because of high intakes of vitamin C supplements among many people
d. no, because non-heme iron blocks the absorption of heme iron
62. Your best friend complains that she is tired all of the time and has a problem concentrating. In addition, she likes to chew ice. Which of the following is your friend likely to have?
a. potassium deficiency
b. zinc deficiency
c. magnesium deficiency
d. iron deficiency
63. What effect does zinc deficiency have on the body?
a. a minor effect because zinc has only a limited role in the body
b. impairs the immune response, leading to increased infections
c. increases metabolism and increases appetite, leading to weight gain
d. reduces iron absorption because iron needs zinc for transport
64. You are working with a child in a health clinic who has growth retardation, impaired immunity, and a poor appetite. This child is most likely experiencing _____ deficiency.
a. iron
b. chromium
c. zinc
d. magnesium
65. Which of the following statements about selenium levels in the body is accurate?
a. men with high blood levels of selenium from taking supplements have decreased cancer risk
b. selenium works as an antioxidant to protect body chemicals from oxidative damage
c. there is no danger of toxicity when taking selenium supplements
d. it is difficult to obtain enough selenium from foods in the diet
66. What is currently known about fluoride in drinking water supplies?
a. All bottled water contains fluoride added as part of the bottling process.
b. Scientific evidence has shown that communities with fluoridated water have higher cancer rates.
c. Very few communities in the U.S. have fluoridated water.
d. In communities where fluoride is lacking in the water there is a very high dental decay rate.
67. What would you tell someone who is considering taking chromium supplements? a Chromium supplements help prevent diabetes in people at risk for developing it.
b. Chromium supplements have been shown to increase muscle mass in athletes.
c. No benefit for reducing body fat with chromium supplements has been proven.
d. There is an increased risk of developing cancer with chromium supplementation.
68. Copper is an essential nutrient because of its role in:
a. forming hemoglobin and collagen.
b. increasing free radical activity.
c. regulating zinc absorption.
d. regulating blood glucose.
69. Which of the following would be the best selection to provide good sources of calcium in the diet?
a. milk, yogurt, and ice milk
b. kefir, butter, and cottage cheese
c. buttermilk, cream cheese, and almonds
d. cheese, cream, and broccoli
Controversy 8 Multiple-Choice Items
70. One of the health concerns with osteoporosis is that:
a. it is a condition that begins developing in the elderly.
b. it affects mainly the cortical bone.
c. it causes hip fractures that fragment into small pieces.
d. it affects only men.
71. The strongest genetic influence on the development of osteoporosis is:
a. the maximum bone mass that can be attained during growth.
b. its influence over the absorption rate of vitamin A.
c. its influence over the amount of bone lost in early adulthood.
d. its effect on estrogen production in young women.
72. Which of the following ethnic groups has the lowest risk for osteoporosis?
a. Asians
b. Hispanics
c. Caucasians
d. Africans
73. Calcium absorption declines in the elderly because:
a. older people tend to lose lean body mass.
b. aging skin is less efficient at making vitamin D.
c. many elderly people get inadequate sun exposure.
d. a and b
e. b and c
74. Osteoporosis is most often associated with:
a. heavier body weights.
b. underweight.
c. higher body fatness.
d. exercise.
75. Bone strength in later life depends on:
a. the increased calcium absorption in the elderly.
b. the increased production of estrogen after menopause.
c. reducing physical activity to protect bones.
d. the formation of dense bones during youth.
76. A young woman wanting to build maximum bone density should do all of the following except:
a. reduce her intake of protein.
b. reduce her sodium intake.
c. limit her intake of regular cola drinks.
d. participate in regular weight-bearing exercise.
77. Which of the following is an accurate statement about calcium supplements for bone health?
a. It is difficult for young women to get enough dietary calcium, so they need a supplement.
b. Calcium-fortified soy milk provides an easily absorbed form of calcium.
c. Calcium supplements are absorbed more readily than calcium in milk.
d. There are no toxicity concerns with taking large amounts of calcium in supplement form.
Use the calcium supplements label to answer questions 78-82.
Suggested use: As a dietary supplement, take two (2) gummy vitamins per day.
Supplement Facts
Serving Size 2 gummy vitamins
Servings Per Bottle 30
Calories 25
Amount Per Serving
% Daily Value*
Total Carbohydrate
6 g
2%
Sugars
5 g
**
Vitamin D
(as cholecalciferol)
1000 IU
250%
Calcium (as tricalcium phosphate)
500 mg
50%
Phosphorus (as tricalcium phosphate)
200 mg
20%
Sodium
15 mg
<1%
* Percent Daily Values are based on a 2,000 calorie diet.
**Daily Value not established.
Other ingredients: Sucrose, glucose syrup, gelatin, pectin, natural flavors, citric acid, lactic acid and colors (black carrot juice extract, annatto extract, carrot and blueberry juices).
This product contains natural colors and flavors. Contains no wheat (gluten), milk, eggs, peanuts, tree nuts or soy.
78. This supplement uses tricalcium phosphate as its source of calcium. What can you state about how well that form is absorbed?
a. It is not absorbed well because of contaminants.
b. It is a form that is absorbed equally well as other forms.
c. It is a form that can accelerate calcium losses from the body.
d. It is absorbed too quickly and may lead to toxic levels.
79. What can you say about the chewable “gummy” form of this supplement?
a. This may interfere with absorption because it has to be chewed.
b. It may be more difficult to swallow.
c. It may enhance the action of stomach acid on the supplement.
d. There are ingredients in the product that interfere with calcium absorption.
80. The amount of calcium in one dose of this supplement:
a. is potentially toxic and should be avoided.
b. is a typical dose found in most calcium supplements.
c. is too low to provide any benefit.
d. can help with magnesium absorption in the body.
81. The vitamin D included in this supplement has what effect?
a. limits the absorption of calcium
b. may increase the risk of fractures
c. can cause toxicity if combined with other vitamin D sources in the diet
d. has no effect on the calcium in the supplement
82. If an individual with diabetes plans to take this supplement, what would be the recommendation?
a. Avoid this supplement because it has a high sugar content.
b. Don’t worry—the amount of carbohydrate in a dose is very low.
c. Because the carbohydrate is in a mineral supplement, it poses no concern.
d. Count the carbohydrate content of the supplement as part of total daily intake.
Essay Items
1.
Identify and explain factors involved in governing water intake and water excretion.
2. Would you discourage someone from purchasing a water softener? Provide a rationale for your answer.
3. What is peak bone mass and when is it developed?
4. Explain the rationale for the following statement: “The way to keep body salt and water weight under control is to control salt intake and drink more, not less, water.”
5. Describe the relationship between salt intake and blood pressure. Who is at greatest risk for adverse effects from excessive sodium intakes?
6. Describe the characteristics of DASH (Dietary Approaches to Stop Hypertension).
7. Differentiate between iron deficiency and iron-deficiency anemia and describe the causes and symptoms of the latter.
8. Explain the rationale for the argument against high-level iron fortification in foods.
9. Describe what is known about the relationship between a protein intakes and bone health.
10. Why do nutrition authorities recommend foods as the source of calcium rather than supplements?
Answer Key (ANS = answer, REF = page reference, DIF = difficulty, OBJ = learning objective)
True/False Items
1. ANS: T REF: 289 DIF: Comprehension-level OBJ: 8.1
2. ANS: F REF: 301 DIF: Comprehension-level OBJ:
8.4
3. ANS: F REF: 305 DIF: Comprehension-level OBJ: 8.4
4. ANS: T REF: 307 DIF: Comprehension-level OBJ: 8.4
5. ANS: T REF: 325 DIF: Comprehension-level OBJ: 8.6
6. ANS: F REF: 290 DIF: Comprehension-level OBJ: 8.1
7. ANS: T REF: 295 DIF: Comprehension-level OBJ: 8.2
8. ANS: T REF: 298-299 DIF: Comprehension-level OBJ: 8.3
9. ANS: F REF: 311 DIF: Comprehension-level OBJ: 8.5
10. ANS: T REF: 319 DIF: Comprehension-level OBJ: 8.5
11. ANS: T REF: 329 DIF: Comprehension-level OBJ: 8.7
12. ANS: T REF: 332 DIF: Comprehension-level OBJ: 8.7
Multiple-Choice Items
1. ANS: c REF: 288 DIF: Comprehension-level OBJ: 8.1
2. ANS: c REF: 288-289 DIF: Comprehension-level OBJ: 8.1
3. ANS: d REF: 288-289 DIF: Comprehension-level OBJ: 8.1
4. ANS: c REF: 290 DIF: Comprehension-level OBJ: 8.1
5. ANS: d REF: 290 DIF: Comprehension-level OBJ: 8.1
6. ANS: d REF: 290 DIF: Comprehension-level OBJ: 8.1
7. ANS: d REF: 291-292 DIF: Comprehension-level OBJ: 8.1
8. ANS: a REF: 294|295 DIF: Comprehension-level OBJ: 8.2
9. ANS: e REF: 294 DIF: Comprehension-level OBJ: 8.2
10. ANS: c REF: 292 DIF: Comprehension-level OBJ: 8.1
11. ANS: b REF: 295 DIF: Comprehension-level OBJ: 8.2
12. ANS: a REF: 296 DIF: Comprehension-level OBJ: 8.2
13. ANS: d REF: 296 DIF: Comprehension-level OBJ: 8.2
14. ANS: d REF: 320 DIF: Comprehension-level OBJ: 8.5
15. ANS: d REF: 298 DIF: Comprehension-level OBJ: 8.3
16. ANS: a REF: 299 DIF: Comprehension-level OBJ: 8.4
17. ANS: b REF: 299 DIF: Comprehension-level OBJ: 8.4
18. ANS: d REF: 300-301 DIF: Comprehension-level OBJ: 8.4
19. ANS: d REF: 300 DIF: Comprehension-level OBJ: 8.4
20. ANS: c REF: 302 DIF: Comprehension-level OBJ: 8.4
21. ANS: a REF: 302 DIF: Comprehension-level OBJ: 8.4
22. ANS: c REF: 303 DIF: Comprehension-level OBJ: 8.4
23. ANS: c REF: 304 DIF: Comprehension-level OBJ: 8.4
24. ANS: d REF: 306 DIF: Comprehension-level OBJ: 8.4
25. ANS: a REF: 307 DIF: Comprehension-level OBJ: 8.4
26. ANS: d REF: 308 DIF: Comprehension-level OBJ: 8.4
27. ANS: a REF: 310 DIF: Comprehension-level OBJ: 8.4
28. ANS: b REF: 323 DIF: Comprehension-level OBJ: 8.4
29. ANS: b REF: 310 DIF: Comprehension-level OBJ: 8.5
30. ANS: d REF: 313 DIF: Comprehension-level OBJ: 8.5
31. ANS: e REF: 316 DIF: Comprehension-level OBJ: 8.5
32. ANS: c REF: 318 DIF: Comprehension-level OBJ: 8.5
33. ANS: c REF: 318 DIF: Comprehension-level OBJ: 8.5
34. ANS: b REF: 319 DIF: Comprehension-level OBJ: 8.5
35. ANS: c REF: 319-320 DIF: Comprehension-level OBJ: 8.5
36. ANS: a REF: 318 DIF: Comprehension-level OBJ: 8.5
37. ANS: a REF: 320 DIF: Comprehension-level OBJ: 8.5
38. ANS: c REF: 324 DIF: Comprehension-level OBJ: 8.6
39. ANS: b REF: 289 DIF: Application-level OBJ: 8.1
40. ANS: a REF: 289 DIF: Application-level OBJ: 8.1
41. ANS: d REF: 289|305 DIF: Application-level OBJ: 8.1|8.4
42. ANS: c REF: 290 DIF: Application-level OBJ: 8.1
43. ANS: c REF: 291 DIF: Application-level OBJ: 8.1
44. ANS: b REF: 294-295 DIF: Application-level OBJ: 8.2
45. ANS: c REF: 291|293-294 DIF: Application-level OBJ: 8.1|8.2
46. ANS: c REF: 294-295 DIF: Application-level OBJ: 8.2
47. ANS: d REF: 295 DIF: Application-level OBJ: 8.2
48. ANS: d REF: 296 DIF: Application-level OBJ: 8.2
49. ANS: b REF: 298 DIF: Application-level OBJ: 8.3
50. ANS: c REF: 297-298 DIF: Application-level OBJ: 8.3
51. ANS: c REF: 301 DIF: Application-level OBJ: 8.4
52. ANS: b REF: 300 DIF: Application-level OBJ: 8.4
53. ANS: a REF: 300 DIF: Application-level OBJ: 8.4
54. ANS: a REF: 302 DIF: Application-level OBJ: 8.4
55. ANS: d REF: 304 DIF: Application-level OBJ: 8.4
56. ANS: b REF: 304 DIF: Application-level OBJ: 8.4
57. ANS: d REF: 304|306 DIF: Application-level OBJ: 8.4
58. ANS: c REF: 306 DIF: Application-level OBJ: 8.4
59. ANS: b REF: 313 DIF: Application-level OBJ: 8.5
60. ANS: c REF: 313 DIF: Application-level OBJ: 8.5
61. ANS: b REF: 316 DIF: Application-level OBJ: 8.5
62. ANS: d REF: 314 DIF: Application-level OBJ: 8.5
63. ANS: b REF: 317 DIF: Application-level OBJ: 8.5
64. ANS: c REF: 317 DIF: Application-level OBJ: 8.5
65. ANS: b REF: 319 DIF: Application-level OBJ: 8.5
66. ANS: d REF: 320 DIF: Application-level OBJ: 8.5
67. ANS: c REF: 320 DIF: Application-level OBJ: 8.5
68. ANS: a REF: 321 DIF: Application-level OBJ: 8.5
69. ANS: a REF: 324 DIF: Application-level OBJ: 8.6
70. ANS: c REF: 328 DIF: Comprehension-level OBJ: 8.7
71. ANS: a REF: 329 DIF: Comprehension-level OBJ: 8.7
72. ANS: d REF: 329|330 DIF: Comprehension-level OBJ: 8.7
73. ANS: e REF: 329 DIF: Comprehension-level OBJ: 8.7
74. ANS: b REF: 330 DIF: Comprehension-level OBJ: 8.7
75. ANS: d REF: 329 DIF: Comprehension-level OBJ: 8.7
76. ANS: a REF: 330-331 DIF: Application-level OBJ: 8.7
77. ANS: b REF: 332-333 DIF: Comprehension-level OBJ: 8.7
78. ANS: b REF: 333 DIF: Application-level OBJ: 8.7
79. ANS: c REF: 333 DIF: Application-level OBJ: 8.7
80. ANS: b REF: 333 DIF: Application-level OBJ: 8.7
81. ANS: c REF: 332|333 DIF: Application-level OBJ: 8.7
82. ANS: d REF: 332|333 DIF: Application-level OBJ: 8.7
Essay Items
1. REF: 289-292 DIF: Comprehension-level OBJ: 8.1
2. REF: 294-295 DIF: Application-level OBJ: 8.2
3. REF: 301 DIF: Comprehension-level OBJ: 8.4
4. REF: 305 DIF: Application-level OBJ: 8.4
5. REF: 305-307 DIF: Comprehension-level OBJ: 8.4
6. REF: 306-307 DIF: Comprehension-level OBJ: 8.4
7. REF: 313-315 DIF: Comprehension-level OBJ: 8.5
8. REF: 316 DIF: Application-level OBJ: 8.5
9. REF: 331 DIF: Comprehension-level OBJ: 8.7
10. REF: 332-333 DIF: Application-level OBJ: 8.7