TVET CURRICULUM DEVELOPMENT, ASSESSMENT AND CERTIFICATION COUNCIL (TVET

CDACC)
QUALIFISCATION CODE:

QUALIFICATION:NUTRITION AND DIETETICS LEVEL 6

UNIT CODE: MED/OS/NUD/CR/03/6

UNIT OF COMPETENCY: APPLY PRINCIPLES OF HUMAN NUTRITION

WRITTEN ASSESSMENT

INSTRUCTIONS TO CANDIDATE
1. This assessment requires you to demonstrate competence against unit of competency:
apply principles of human nutrition

2. You have ONE HOUR AND THIRTY MINUTES to attempt all the
questions.
3. Marks for each question are indicated in brackets ( ).
4. This paper consists of THREE sections: A, B and C

SECTION A (15 MARKS)

1. THE CLIENT BRINGS THE RESULTS OF RECENT CHOLESTEROL SCREENING WITH HIM TO SEE
YOU THE NUTRITIONIST. THE CLIENT IS CONFUSED ABOUT WHAT THE RESULTS MEAN AND ASK
YOU WHAT THE TOTAL CHOLESTEROL NUMBER SHOULD BE. WHICH OF THE FOLLOWING
STATEMENTS WOULD YOU MAKE ABOUT INTERPRETING THE RESULTS OF THE CHOLESTEROL
SCREENING TEST?(2marks)
A.TOTAL BLOOD CHOLESTEROL SHOULD NOT EXCEED 150 MG/DL

C.TOTAL CHOLESTEROL SHOULD NOT EXCEED 150 MG/ML

B.TOTAL CHOLESTEROL SHOULD NOT EXCEED 200 MG/DL

D.TOTAL CHOLESTEROL SHOULD NOT EXCEED 200 MG/ML

2. YOU AS A NUTRITIONIST , YOU ARE TEACHING A GROUP OF CLIENTS IN A CARDIAC

REHABILITATION CLASS ABOUT FOOD SOURCES OF PROTEINS. IN WHAT FOODS WILL YOU SAY
PROTEIN IS FOUND?(2marks)

A.IN FOODS DERIVED FROM BOTH PLANT AND ANIMAL FOODS

C.ONLY IN FOODS DERIVED FROM PLANTS

B.ONLY IN FOODS DERIVED FROM ANIMALS

D.ONLY IN FORTIFIED FOODS

3. YOU ARE INVITED AS NUTRITIONIST IN A SCHOOL TO MAKE A PRESENTATION TO PARENTS OF

TEENAGE STUDENTS. ONE PARENT IS CONCERNED THAT THEIR CHILD IS NOT GETTING
ADEQUATE HIGH QUALITY DIETARY PROTEIN BECAUSE THE CHILD HAS STOPPED EATING MEAT.
WHICH OF THE FOLLOWING STATEMENTS WOULD YOU MAKE ABOUT VEGETARIAN DIETS AND
PROTEIN?(2marks)

A.ALL VEGETARIAN DIETS DELIVER ADEQUATE HIGH QUALITY DIETARY PROTEIN

C.LACTO-OVO VEGETARIAN DIETS DELIVER ADEQUATE HIGH QUALITY DIETARY PROTEIN

B.FRUITARIAN DIETS DELIVER ADEQUATE HIGH QUALITY DIETARY PROTEIN

D.VEGAN DIETS DELIVER ADEQUATE HIGH QUALITY DIETARY PROTEIN

EXPLAIN WHY.

GET ADEQUATE PROTEIN ON A VEGAN DIET PRESENTS NO PROBLEM AT ALL. BOTH NUTS AND
SEEDS SUCH AS LEGUMES, WHOLE GRAINS AND SOY PRODUCTS PROVIDE PROTEIN.
PREVIOUSLY IT WAS BELIEVED THAT PLANT PROTEINS WERE OF LOWER QUALITY THAN ANIMAL
PROTEINS IN WHICH AMINO ACID CONTENT IS CONCERNED. HOWEVER, THIS BELIEF HAS
BECOME OUTDATED AND THAT IF YOU FOLLOW A DIET BASED ON BALANCED VEGETABLE
PRODUCTS, WILL RECEIVE ALL THE NECESSARY AMINO ACIDS IN ADEQUATE AMOUNTS. THE
VEGAN DIET HAS SEVERAL INCOMPLETE PROTEINS TO MAKE A COMPLETE ONE, BUT THAT
SHOULD BE EATEN THE SAME DAY, THE ESSENTIAL AMINO ACIDS CAN ALSO BE FOUND IN SOY
PRODUCTS AND TOFU.

4. A PREGNANT CLIENT TELLS YOU THAT SHE IS TAKING MEGADOSES OF VITAMIN A IN THE
HOPES THAT IT WILL KEEP HER COMPLEXION CLEAR THROUGHOUT THE PREGNANCY. WHAT
WOULD YOU AS A NUTRITIONIST SAY ABOUT HER USE OF THIS VITAMIN SUPPLEMENT?
(2marks)

A.CONSUMING MEGADOSES OF VITAMIN A MAY CAUSE PERMANENT NIGHT BLINDNESS.

B.CONSUMING MEGADOSES OF VITAMIN A MAY RESULT IN BIRTH DEFECTS.

C.TAKING MEGADOSES OF VITAMIN A ARE A GOOD IDEA DURING PREGNANCY BECAUSE

VITAMIN A SUPPORTS A HEALTHY IMMUNE SYSTEM.

D.TAKING MEGADOSES OF VITAMIN A WILL NEITHER HELP NOR HURT HER OR THE FETUS
DURING THE PREGNANCY.

ANSWER: B) CONSUMING MEGADOSE OF VITAMIN A MAY RESULT IN BIRTH DEFECT.

EXPLAIN YOUR ANSWER.

BIRTH DEFECTS CAN OCCUR IF THE SUPPLEMENT THAT HAS HIGH DOSES OF RETINOL INGESTED
FOR A WHILE, SEVERAL DAYS OR WEEKS AND ESPECIALLY DURING THE FIRST TRIMESTER OF
PREGNANCY.

VITAMIN A IS AN ESSENTIAL MICRONUTRIENT FOR GROWTH OF THE HUMAN BODY, THE TISSUE
TROPISM OF EPITHELIAL ORGANOGENESIS, EPITHELIAL DIFFERENTIATION AND EMBRYONIC
DEVELOPMENT. INTAKE, ACUTE OR CHRONIC HIGH AMOUNTS OF VITAMIN A CAN CAUSE
VARIOUS CLINICAL MANIFESTATIONS SUCH AS HEADACHE, VOMITING, DIPLOPIA, ALOPECIA,
DRY MUCOUS MEMBRANES, SKIN PEELING, BONE ABNORMALITIES AND LIVER DAMAGE.

VITAMIN A AND RETINOIDS ARE TERATOGENS CLASSICS. MALFORMATIONS THAT ARE

GENERATED DEPEND ON THE DOSES USED AND TIMING OF ORGANOGENESIS IN WHICH THEY
ARE PROVIDED. DURING EARLY ORGANOGENESIS RESULT IN ABNORMALITIES OF THE CENTRAL
NERVOUS AND CARDIOVASCULAR SYSTEM, WHILE A LATER PROVISION GIVES RISE TO GENETIC
DEFECTS IN THE UPPER AND LOWER GENITOURINARY TRACT AND PALATE. RETINOIDS DERIVED
FROM THE CATABOLISM OF VITAMIN A MOTHER’S DIET ARE TRANSFERRED TO THE EMBRYO-
FETAL COMPARTMENT.

5. YOUR FAMILY MEMBER WHO IS AN ELDERLY CONTACTS AS A PROFESION IN NUTRITION

AND ASKS WHY HE IS RECEIVING B12 INJECTIONS. WHICH OF THE FOLLOWING ANSWERS
WOULD YOU GIVE HIM?(2marks)

A.THE INJECTIONS OF B12 ARE GIVEN TO PREVENT BLINDNESS.

C.THE INJECTIONS OF B12 ARE GIVEN TO PREVENT PELLAGRA

B.THE INJECTIONS OF B12 ARE GIVEN TO PREVENT BERIBERI

D.THE INJECTIONS OF B12 ARE GIVEN TO PREVENT PERNICIOUS ANEMIA

ANSWER: D THE INJECTIONS OF B12 ARE GIVEN TO PREVENT PERNICIOUS ANEMIA

EXPLAIN WHY.

PERNICIOUS ANEMIA IS A DECREASE IN RED BLOOD CELLS THAT OCCURS WHEN THE BODY CAN
NOT PROPERLY ABSORB VITAMIN B12 FROM THE DIGESTIVE TRACT. THIS VITAMIN IS
NECESSARY FOR THE PROPER DEVELOPMENT OF RED BLOOD CELLS. THE BODY NEEDS VITAMIN
B12 TO PRODUCE RED BLOOD CELLS. IN ORDER TO PROVIDE VITAMIN B12 IN THEIR CELLS, YOU
SHOULD EAT ENOUGH FOODS THAT CONTAIN THIS VITAMIN, SUCH AS BEEF, POULTRY,
SEAFOOD, EGGS AND DAIRY PRODUCTS (AC ANTONY, 2008).

TO ABSORB VITAMIN B12, YOUR BODY USES A SPECIAL PROTEIN CALLED INTRINSIC FACTOR,
SECRETED BY CELLS IN THE STOMACH. THE COMBINATION OF VITAMIN B12 ATTACHED TO
INTRINSIC FACTOR IS ABSORBED IN THE LATTER PART OF THE SMALL INTESTINE. WHEN THE
STOMACH DOES NOT PRODUCE ENOUGH INTRINSIC FACTOR, THE INTESTINE CAN NOT ABSORB
THE VITAMIN PROPERLY. THE DISEASE BEGINS SLOWLY AND MAY TAKE DECADES TO FULLY
ESTABLISH. ALTHOUGH THE CONGENITAL FORM OCCURS IN CHILDREN, PERNICIOUS ANEMIA
USUALLY DOES NOT OCCUR BEFORE AGE 30 IN ADULTS AND THE AVERAGE AGE AT DIAGNOSIS
IS 60 YEARS. MONTHLY INJECTIONS OF VITAMIN B12 ARE PRESCRIBED TO CORRECT THE
DEFICIENCY OF THE VITAMIN. THIS THERAPY TREATS THE ANEMIA AND MAY CORRECT THE
NEUROLOGICAL COMPLICATIONS IF TAKEN SOON ENOUGH. IN PEOPLE WITH A SEVERE
DEFICIENCY, INJECTIONS ARE GIVEN MORE FREQUENTLY AT FIRST( MEDLINEPLUS).

6.YOU AS AS A REGISTERED NUTRITIONIST WHAT IS THE VALUE OF DIGESTABLE DIETARY

VALUE OF CARBOHYDRATE. (1MARK)

A. 4
B. 10
C. 7
D. 9

7.WHAT IS THE FUNCTION OF INSULIN IN THE BODY. (1MARK)

A. BONE GROWTH
B. LOWERING BLOOD GLUCOSE LEVEL
C. CONVERTING CARBOHYDRATE FOR BODY FAT
D. STIMULATING OF HUNGER

8.DIETS HIGH IN FIBRE TEND TO BE LOW IN …………AND ……….; DIETS HIGH IN FIBER TEND TO BE
RICH IN …………….. AND ………………………(2MARKS)

A. FAT, SUGER, PHYTOCHEMICALS, MINERALS

B. PHYTOCHEMICALS,MINERALS, FAT,VITAMINS
C. VITAMINS, MINERALS, KCALS, FAT
D. SUGAR, MINERALS, VITAMINS, FAT

SECTION B (30 MARKS)

1. (A) COMPLETE THE TABLE BELOW TO SHOW THE ELEMENTS SUPPLIED TO THE BODY BY
DIFFERENT NUTRIENTS, AND THE AMOUNT OF ENERGY EACH PROVIDES. [4 MARKS]
CLASS OF NUTRIENT ELEMENT AMOUNT OF ENERGY (KCAL G-1)

PROTEINS

CARBOHYDRATES

LIPIDS

ALCOHOL

(B) YOU ARE INVITED BY YOUR AREA CHIEF IN THE VILLAGE BARAZA AS A NUTRITIONIST TO
EDUCATED PEOPLE ESSENTIAL NUTRIENTS, WHAT WILL YOU TELL THE VILLAGER ESSENTIAL
NUTRIENTS ARE? . [1 MARK]

AN ESSENTIAL NUTRIENT IS A NUTRIENT REQUIRED FOR NORMAL BODY

FUNCTIONING THAT CAN NOT BE SYNTHESIZED BY THE BODY.

(C) WHICH THREE CLUES WILL YOU GIVE THEM TO BE USING IN IDENTIFYING ESSENTIAL
NUTRIENTS . [3 MARKS]

 REQUIRED FOR NORMAL FUNCTIONING OF THE BODY

 CAN NOT BE SYTHESIZED BY THE BODY
 THEY ARE TOXIC IN LARGE DOSES

(D) TELL THEM ONE SITUATION DURING WHICH THE BODY HAS A HIGHER PROTEIN NEED AND
EXPLAIN WHY. [2 MARKS]

2. (A) ENLIGHTEN THE MEMBERS OF YOU CHURCH WHY CONSUMING PLANT PROTEINS IS OF
MUCH BENEFITS THAN ANIMAL PROTEINS. [3 MARKS]

(B) WHAT ADVICE WILL YOU GIVE TO THE MOTHERS WHO FEED THEIR INFANTS HONEY
DURING THE RADIO INTERVIEW AS A NUTRITIONIST. [2 MARKS]
3. (A) WHAT ARE THE TWO FUNCTIONS OF EACH OF THE FOLLOWING ORGANS AS FAR AS
NUTRITION IS CONCERNED

(I) LIVER [1 MARK]

(II) PANCREAS [1 MARK]

4. (A) PEOPLE AROUND AS YOU WHO HAVE INSUFFICIENT KNOWLEDGE ABOUT NUTRITION ARE
DEBATING ABOUT OMEGA-3 AND OMEGA-9. AS A NUTRITION SHED SOME LIGHT ABOUT THE
TWO OMEGA FATTY ACIDS WITH RESPECT TO THEIR AVAILABILITY TO THE BODY. [2 MARKS]

(B) CIRRHOSIS OF THE LIVER HAS BECOME A COMMON DISEASE AMONG THE ALCOHOL
CONSUMERS. AS A NUTRITIONIST TELL ROUTINE HEAVY ALCOHOL CONSUMERS HOW THIS
DISEASE DEVELOPS IN AN INDIVIDUAL AS A RESULT OF ALCOHOL OVERCONSUMPTION. [3
MARKS]

5. CITING EXAMPLES, BRIEFLY EXPLAIN WHETHER THE RISK OF OBESITY IS INCREASED BY

GENETIC OR ENVIRONMENTAL FACTORS. [5 MARKS]

SECTION B (50 MARKS)

6. WHAT ARE THE TEN EFFECTS OF VITAMIN A DEFICIENCY IN THE HUMAN BODY. [20 MARKS]

7. A.WHAT ARE THE FIVE CAUSES, SYMPTOMS AND TREATMENT OF FOOD ALERGIES. [20
MARKS]

8. WHAT ARE THE FIVE FUNCTIONS OF TRIGLYCERIDES IN THE BODY. [10 MARKS]