Certified Dietary Manager's Role in Client Meal Service, Exams of Nursing

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Det 117- Final Exam Questions and Answers 2024

1. What should the Certified Dietary Manager do when a client using a selec- tive menu insists on ordering food that is not on her diet?: answer- The client should be educated on their diet but their rights may overrule their dietary restrictions. Diet conflicts should be referred to clinical nutrition staff and documented on the medical record.
2. What is the difference between centralized and decentralized meal ser- vice?: answer- Centralized meal services are designed to produce large quantities of food items and decentralized meal services are designed only for finishing or reheating prepared food items. Centralized meal services produce the food that will be sent to decentralized meal services.
3. When making changes in dining services, what must the Certified Dietary Manager must remember the implement first?: answer- Change the language used Change the type of service Begin with questioning clients about what they want
4. How many hours may be between dinner/supper and breakfast?: answer- 14 hours
5. Rethermalization: answer- reheating of food prior to service
6. What results when there are delays in meal delivery?: answer- Complaints about food temperature and quality may arise if there are delays in meal delivery and distribution.

If there is a delay in meal delivery and distribution it also brings up concerns about food safety.

7. What is the most important consideration in menu planning?: satisfying your clients
8. What is the best way for a Certified Dietary Manager to ensure clients follow their diet when selecting food for meals?: staff should be trained to address a client's diet when they drop off the menu review each individual menu before the meal is served to a client. computer systems can review menu choices to check for compliance, calculate totals of restricted nutrients, eliminate allergenic foods, and automate food additions.
9. How does managing menus soundly and realistically relate to the substitu- tion process?: planned and organized as part of the menu
10. How does the CDM keep a kosher kitchen?: separates the meat from the dairy while cooking
11. What is the importance of providing clients with a choice of foods?: control over their care, helps improve nutritional intake, and improves quality of life
12. What is the importance of a standardized recipe?: ensures that a consistent quality product can be made regardless of who is cooking ensures that the recipe can be repeated over and over again by many staff members with the same desired outcome ensures a consistent quality, appearance, and taste.
13. What is the advantage of a recipe being very specific?: can be repeated again and again by many different staff members and still have the same consistent

quality, taste, and appearance

14. conversion factor: the number by which you adjust each recipe ingredient to arrive at a new yield
15. standardized recipe: a recipe that contains detailed specifications and has been adapted and tested in your operation
16. Why is portion control essential?: control the number of servings for a product and for building client satisfaction clients are more satisfied when their portion sizes are predictable and consistent.
17. Using liquid or processed eggs meet which food safety regulation?: The food safety regulation that prohibits the pooling of eggs
18. What determines the flavor of natural cheese?: type of milk and the length of time the cheese is aged
19. Why is unsalted butter used in some baking recipes?: butter flavor is more pronounced
20. What is the maximum temperature to cook cheese to prevent curdling and toughness?: a low temperature no higher than 350 degrees
21. What is an advantage for ultra-high-temperature pasteurized milk?: can be held for up to three months without refrigeration
22. What is an advantage for irradiating meat?: safer an extended shelf life.
23. What is a roux?: made from equal parts fat and flour and used to thicken sauces and gravies
24. What is dry lab?: recording temperatures without actually taking them.
25. How would the Certified Dietary Manager verify that the temperatures are

correct and haven't been dry labbed?: procedures in place to monitor tempera- ture and that these procedures are working. review HACCP logs for accuracy and completeness of temperature monitoring and take corrective action when necessary. always take corrective action regarding problems with temperature monitoring as quickly as possible have a policy in place that requires foods to be tested prior to service.

26. What is the main purpose of forecasting?: knowing how much food to pro- duce and how much food to order
27. What are the elements of a standardized recipe?: - title

• category
• recipe number
• yield
• batch quantity
• portion size, - ingredients
• weights and measures
• food safety information
• HACCP
• direction or procedures
• pan size
• batch unit
• scaling
• nutrition information

• recipe sources

28. What is a production schedule?: A document that outlines what to produce, how much to make, and who is responsible
29. What type of malnutrition is commonly seen today?: Protein and calorie malnutrition
30. What is the difference between enteral and parenteral nutrition?: Enteral Nutrition-supplemental feeding by mouth or by tube, of liquid formulas that contain essential nutrients Parenteral Nutrition-the administration of simple essential nutrients into a vein
31. What can be done to encourage the best acceptance of nutrition supple- ments?: Allowing clients to taste supplements and choose what they find most enjoyable Serving liquid supplements very cold
32. What is important to consider if staff is passing out snacks?: In some set- tings supplements are included on the Medical Administration Record and nursing is required to verify consumption of the item (s) on the MAR Staff must understand dietary restrictions and make sure that foods offered meet the dietary order.
33. What should be done if a client is not accepting a nutritional supplement as care planned by the Interdisciplinary team?: - The client has a right to refuse supplements.

• The CDM should alert the clinical nutrition staff so that the client, facility, Medical Care Provider, and RDN can collaborate to identify alternatives.

34. What is the clear focus of the foodservice department?: the clients you

provide dining services to.

35. Who are the clients/customers of the foodservice department?: people who buy your goods and services Anyone you provide meal service to is considered your client In healthcare facilities clients will include clients and patients of the facility, staff that work at the facility, and family members that visit the facility. Clients may also include members of the community if you provide a homebound meal service or conference and meeting attendees if you are holding an event.
36. What is required for the success of a foodservice operation?: Satisfying client needs while also managing additional constraints
37. What do closed questions provide for multiple choice answers in a sur- vey?: A question with a limited number of answers such as yes or no Can help develop specific figures that identify areas for action and measure trends over time
38. What needs to happen when conducting a survey using open ended questions?: Do not ask leading questions Make the question neutral
39. How are quality indicators used?: Used to measure outcomes
40. What is the focus of quality care?: clients and what they need
41. Describe quality assurance processes.: overall structure, processes, and pro- cedures designed to ensure that the facility meets or exceeds an expected standard of quality
42. What is quality assessment?: evaluation of processes and/or outcomes to

determine if a defined standard of quality is being achieved

43. What is the main reason for establishing quality standards?: ensure that your operation is meeting certain standards
44. What is the advantage of developing a taste panel for the foodservice department?: can help the foodservice department determine whether or not a product meets the given standards and may help improve client satisfaction with the food
45. Turnover Rate: Number of employees who left/Avg number of employees= turnover rate
46. Conversion Factor Formula: New Yield/Original Yield
47. FTE formula: Total Number of Hours Paid in a Year or Week/The Number of Hours in Your FTE Definition
48. Define chain of command.: the flow or formal power through organizational lines
49. Americans with Disabilities Act: Requires reasonable accommodations for disabled persons Requires covered organizations to take steps to accomodate disabled persons, including employees, and to employ qualified disabled applicants
50. What does the Equal Employment Opportunity Commission oversee?: Pro- vides the oversight for federal employment legislation
51. How many staff members does a facility need to employ to be governed by the regulations of the Equal Employment Opportunity Commission?: 15 or more
52. What are the characteristics of conduct to be considered sexual harass- ment?: Physical, Verbal, or Visual

53. Under what legislation does the requirement to provide overtime pay come?: The Fair Labor Standards Act
54. When should new employees receive sanitation training?: Orientation, as needed, and annually
55. How involved should the CDM be with new employees who are completing a probationary period?: CDM should complete The Onboarding Process-the sum of all orientation activities Help ensure that all staff members are fully aware of policies and expectations that affect them.
56. Describe an objective. What is key to grammar?: Outcomes of the training. Begins with an action verb and should fit the SMART (Specific, Measurable, Achiev- able, Relevant, Timely) principle
57. What is the first step in planning training?: Determine the need-who and what should be offered
58. What topic should the Certified Dietary Manager provide training on an annual basis and as needed?: Sanitation Training
59. What is an easy way for foodservice staff to receive training?: On the Job Training
60. Define cross training.: Training an employee to do more than one job
61. How can the Certified Dietary Manager eliminate staff all asking for time off at the same time?: Plan a written schedule at least one week prior to the start of the schedule Try to establish regular days off for each staff member

If there is to a change in the regular schedule, make the employee aware Avoid scheduling double back assignments Be fair, rotate weekends and holidays When given the opportunity to work it

62. What is an FTE?: One person working full time
63. What is the advantage of creating a split shift?: Part time staff hired to work short shifts
64. What type of scheduling involves having staff check in and start work according to need and not scheduled to begin and end at the same time?: - Temporary or as needed employees work according to need
65. When would adjustments have to be made to add more staffing hours?: - When the census or level of activity increases
66. What does a performance standard measure?: measure quality of the work performed
67. What is a significant cost to a facility?: Employee Turnover
68. Why is it important to perform an exit interview?: An interview with the employee who is leaving the organization Often provides valuable information which the organization can use to improve employee retention
69. How may a performance review best help an employee?: - Identifies needs for improvement and growth

• Serves as a formal basis for wage increases related to performance
• Provides an opportunity for an employee to set personal work objectives that relate

to the departmental objectives

• Provides an opportunity for the employee to raise needs related to work and for the supervisor/manager to help
• May be used to evaluate eligibility for promotion
• Groundwork for motivation
• Can help improve relationship between employee and CDM

70. How may the Certified Dietary Manager best help employees reach their full potential?: Train and develop staff
71. What is the best benefit to address employee's personal problems?: Em- ployee Assistance Program Provides support to employees in solving personal problems that may be interfering with work such as drug and alcohol abuse, family problems, teamwork problems
72. What may help a Certified Dietary Manager retain employees?: - Treat em- ployees like clients

• Provide an atmosphere of trust and support
• Reward employees for doing a good job and deal fairly with those who do not

73. What is the best way to motivate staff?: - Match employee's goals with those of the department

• Inservices and on the job training
• Provide for basic needs and support the development and advancement of staff

members

74. Goal: A statement that outlines an outcome or result Outlines a broad direction or intention
75. Objective: The steps to achieve the goal of the actions that lead to the goal Specific step that will help in accomplishing the goal
76. Why is it important to involve staff when designing action plans for changes in the menu?: Increases their level of engagement in the department
77. How may the CDM motivate employees to practice safe food handling practices?: Inservices and on the job training
78. What is the most appropriate tool to determine which employee to delegate tasks to?: Organization chart
79. What is the next step for foodservice department after developing goals and objectives?: Continue the planning process with a list of tasks to be accom- plished in the action plan
80. Why is it important to document what happens during a meeting?: Can be used as a reference for the next meeting or an ongoing project Documentation that employees receive training
81. What types of activities would be considered a violation of ethics?: Dis- closing patient information to others Accepting gifts
82. How should the CDM handle a disagreement starts between two employ- ees about a topic that is not on the agenda during a meeting?: - Do not get involved, state and summarize the the member's ideas and let the group decide

upon their value

• If a meeting brings out a conflict or a problem that is not part of the meeting's pur- pose recognize it as important and set aside a separate time for it to be addressed

83. What is the best reason for preparing a meeting agenda with time frames for each agenda items?: To accomplish all of the objectives of the meeting
84. When would it be appropriate to brainstorm during a meeting?: Asking all participants to suggest ideas for solving a problem
85. How may the CDM scheduling meetings in a large facility with more than one shift?: - Hold the same meeting at different times

• Stagger meetings/have them in small groups

86. What is an action plan?: A plan of action to accomplish specific goals and objectives
87. What elements are necessary for written communication to be effective?- : Sounds like a professional speaking to you face-to-face
88. What type of communication would be best to communicate a new proce- dure for punching into the timeclock?: Downward Communication
89. Describe change.: - Anything that requires revision in the roles and routines of a workforce A continuous process and not an activity with a distinct start and finish Can generate excitement, commitment, and pride but should be managed in a way that can help employee feel positively about it
90. What is the appropriate temperature for water in a hand washing sink?: At least 100 degrees F

91. What is the best fire extinguisher to use in a foodservice operation?: Mul- tipurpose Dry Chemical Type
92. What is the exception to bare hand contact with ready-to-eat food?: when washing fruits and vegetables
93. What pathogens are most likely transferred through bare hand-contact?: - Norovirus Shigella Hepatitis A Salmonella Typhi Nontyphoidal Salmonella Shiga Toxin Producing E. Coli
94. How does OSHA define a work-related injury?: Injury that occurs at work that results in days away from work, restricted work activity, medical treatment, loss of consciousness, or death
95. How can the Certified Dietary Manager help make safety inspection every- one's job?: Involve all employees in safety audits
96. What temperature should the dry storage area should be kept?: 50 - 70 degrees F
97. What does FIFO ensure?: First In, First Out A storage practice to ensure that older products are used first
98. How many day should Shellfish Identification Tags must be kept?: 90 days
99. What is the desired height of storage shelving from the floor?: 6 inches
100. What is the correct temperature for receiving fluid milk?: At or below 41

degrees F

101. Why is it acceptable or unacceptable to cover storage shelves with alu- minum foil or other material?: it does not allow for proper air circulation
102. What is FOTTWA?: Conditions needed for bacterial growth Food, Oxygen, Temperature, Time, Water, Acidity
103. What is the hazard zone temperature range?: The danger zone 41 degrees F to 135 degrees F
104. What is a foodborne illness?: A disease that is transmitted by food
105. How many ill people eating similar food must be reported to be classified as a foodborne illness outbreak?: Two or more
106. What is PHF/TCS?: TCS- Time and temperature control, needed to prevent the growth of pathogens or the formation of toxins in food Formerly now as Potentially Hazardous Foods (PHF)
107. What is the maximum number of hours for potentially hazardous foods be held in the hazard zone?: 4 hours
108. What has been shown to be in the top five causes of foodborne illness outbreaks?: Improper Holding Temperatures Contaminated Equipment Poor Personal Hygiene Inadequate Cooking Food From unsafe Sources
109. Why may a HACCP based inspection take several days?: The inspector will review the HACCP logs during the visit allowing the inspector to inspect food safety

practices over a long period of time rather than just on the day of the inspection

110. What is back-siphonage?: After a loss in pressure in the water supply and water is siphoned back into the drinkable water supply
111. Define sanitary.: Free of harmful levels of microorganisms
112. What is the main focus of integrated pest management?: A coordinated approach to pest control, food production and dining services to manage pests and prevent them
113. How often does the FDA recommend that foodservice operations be inspected?: Once every six months
114. What should you do when the health inspector comes to complete a review of your establishment?: Ask for identification and reason for inspection Show professional courtesy Accompany inspector through facility
115. monthly raw food costs: Beginning Inventory Plus Purchases Minus Ending Inventory
116. cost per serving: Cost/Number of Servings
117. Define a fiscal year.: The 12 month or 52 week period for which a budget applies
118. Define specification.: A detailed description providing information needed to purchase a piece of equipment
119. What is the typical minimal dollar amount of purchases included in a Capital budget?: Generally covers purchases larger than $1,000 but in some facilities it could be up to $5,
120. What information will be required annually when updating the capital budget?: Review and update the status of every piece of equipment on the list

including the estimated remaining life

121. What may be a desirable way to get a price break on capital equipment?- : Long term leasing of equipment
122. What type of lighting is considered for florescent ceiling lights?: Ambient or general lighting The level of brightness is intended to provide light without glare or significant shadows
123. What needs to be developed before deciding what type of steamer to purchase?: Specification
124. Where should receiving areas be located in a foodservice facility design?- : As close as practical to storage areas
125. Why would a Certified Dietary Manager consider ergonomic factors when purchasing equipment?: influence the comfort, efficiency, and safety of a work environment Help control physical fatigue and prevent injury related to repetitive motion
126. When is an RFP (Request for Proposal) usually used?: A written description of large dollar items that is then sent to a supplier to obtain a competitive bid
127. What is the first step in a preventative maintenance program?: Identify and list all equipment in the food production and dining services facility that need periodic inspection and maintenance
128. How does the CDM begin a formal bidding process?: The CDM or man- agers invites suppliers to submit sealed bids on a detailed, written prospective order. The manager reviews written responses and makes a selection.

129. What is the purchase unit for applesauce packed in #10 cans with six cans per case?: Purchase unit- package, container, or unit in which a product is purchased Case
130. Define cherry picking.: A purchase concept where individual products are purchased from individual vendors, usually based on price alone.
131. Define perpetual inventory system.: A running count of inventory that is updated continuously
132. Define physical inventory.: A physical count of items in inventory that occurs weekly, monthly, quarterly, or annually
133. Define inventory valuation.: The dollar figure of all inventory on hand at a given time
134. What is the objective of revenue generating services?: Increase gross revenue in the operating statement
135. What is a break even analysis?: financial calculation that compares costs with revenues to determine if a profit is possible
136. What is a profitability analysis?: financial calculation that compares costs with revenues to determine whether an idea is profitable
137. What is a minimum time-line for the expected level of sales when deter- mining the break-even point?: The time that will be required to break even or pay off the investment It is not unusual for the break-even point to occur 12 or 18 months down the line on a business plan
138. What does a balance sheet show?: A snapshot showing assets, liabilities,

and net asset on a given day in time - usually the last day of the financial period

139. What is another name for a Profit and Loss Statement?: Operating State- ment
140. What does it indicate when a figure is seen as ($XX) on a monthly budget report?: Parentheses on the operating statement are used to show places where the actual values represent an operating loss for this budget category
141. What is the primary responsibility for a Certified Dietary Manager in managing a budget?: Help meet the financial objectives of the facility and maintain financial viability
142. What would be the best way to cut the hours for a census drop?: Reduce hours among all employees
143. What information does a food usage record provide?: Shows what food has been issued to the serving area, what is left over, and what has actually been used