ALF Dietary and Nutritional Services 2 — Questions and Answers
Question 1: A resident with dysphagia has been prescribed a mechanically altered diet. What is the administrator's primary responsibility regarding this order?
- Change the diet texture based on family preference
- Personally supervise every meal served to the resident
- Require the resident to sign a waiver before serving altered food
- Ensure the dietary staff receives and implements the physician's or dietitian's order accurately (Correct answer)
Correct answer: Ensure the dietary staff receives and implements the physician's or dietitian's order accurately
The administrator must ensure systems exist so therapeutic diet orders are communicated to and correctly implemented by dietary staff.
Question 2: How long must potentially hazardous leftover foods generally be kept before they must be discarded in an assisted living facility?
- There is no limit if the food is reheated to 165°F
- 24 hours regardless of storage method
- No more than 72 hours when refrigerated and properly labeled with a date (Correct answer)
- Up to 7 days as long as they are frozen
Correct answer: No more than 72 hours when refrigerated and properly labeled with a date
Most food safety standards require refrigerated leftovers to be labeled, dated, and discarded within about 72 hours.
Question 3: A resident on a physician-ordered low-sodium diet repeatedly requests regular table salt. What is the most appropriate facility response?
- Refuse the request because the diet order is legally binding on the resident
- Secretly substitute a salt-free seasoning without telling the resident
- Discharge the resident for noncompliance
- Document the resident's informed choice after educating them on the risks and notifying the physician (Correct answer)
Correct answer: Document the resident's informed choice after educating them on the risks and notifying the physician
Residents retain the right to make informed choices, so the facility educates, documents, and notifies the physician rather than forcing compliance or deceiving the resident.
Question 4: What is the maximum amount of time that is generally permitted between the evening meal and breakfast the next morning?
- 8 hours in all circumstances
- 18 hours if the resident agrees
- 14 hours, unless a nutritious snack is offered at bedtime (Correct answer)
- There is no regulatory limit on meal spacing
Correct answer: 14 hours, unless a nutritious snack is offered at bedtime
Regulations commonly limit the overnight span between dinner and breakfast to about 14 hours, which may be extended slightly when a substantial bedtime snack is provided.
Question 5: During a kitchen inspection, the administrator finds raw chicken stored on a shelf above ready-to-eat salads in the walk-in cooler. Why is this a violation?
- Chicken must always be stored in a separate building
- Salads must be stored at room temperature
- Raw meat may never be refrigerated with any other food item
- Raw poultry juices can drip onto ready-to-eat food and cause cross-contamination (Correct answer)
Correct answer: Raw poultry juices can drip onto ready-to-eat food and cause cross-contamination
Raw meats must be stored below ready-to-eat foods so drips cannot contaminate items that will not be cooked before serving.
Question 6: Which staff member is typically required to review and approve therapeutic diet menus in an assisted living facility?
- The maintenance supervisor
- Any certified nursing assistant on duty
- The activities director
- A registered or licensed dietitian/nutritionist (Correct answer)
Correct answer: A registered or licensed dietitian/nutritionist
Therapeutic menus generally must be reviewed and approved by a qualified dietitian or nutrition professional.
Question 7: A resident begins losing weight unintentionally over several weeks. What should the facility's dietary and care systems trigger first?
- Removal of all dietary restrictions without consultation
- An immediate switch to tube feeding
- A nutritional assessment and notification of the resident's physician (Correct answer)
- A mandatory increase in meal portion sizes for all residents
Correct answer: A nutritional assessment and notification of the resident's physician
Unplanned weight loss should trigger assessment and physician notification so causes can be identified and an individualized plan developed.
ALF Dietary and Nutritional Services 2
A resident with dysphagia has been prescribed a mechanically altered diet.
What is the administrator's primary responsibility regarding this order?