Jemshah · KNEC Diploma in Food and Beverage Management · Module II
Nutrition, Diet Therapy and Home Nursing Theory — June/July 2023
Paper: 2802/202 · Time: 3 hours
Answer ALL questions in Section A and any FOUR questions in Section B.
Questions are transcribed from the supplied KNEC paper. Answers are independent study explanations, not an official KNEC marking scheme. Attempt each part before reading its Answer.
SECTION A (20 marks)
Answer ALL questions in this section.
Question 1(a)
Answer
- Provides energy for activity and body processes.
- Supplies materials for growth and tissue repair.
- Provides nutrients that regulate metabolism and body functions.
- Supports immunity and maintenance of good health.
Question 1(b)(i)
Answer
Gastro-oesophageal reflux disease is persistent or troublesome backward flow of stomach contents into the oesophagus, causing symptoms or complications such as heartburn and irritation.
Question 1(b)(ii)
Answer
A burning discomfort behind the breastbone, commonly caused by stomach acid refluxing into the oesophagus. It is a symptom, while GERD is a disease condition involving troublesome reflux.
Question 1(c)
Answer
- Comfort of familiar surroundings.
- Support and contact with family or trusted carers.
- Care can be adapted to normal routines and individual preferences.
- May reduce travel and institutional care costs when suitable support is available.
Question 1(d)
Answer
- Pancreatitis, when a lower-fat diet is indicated.
- Fat malabsorption with steatorrhoea.
- Severe hypertriglyceridaemia, where specialist fat restriction is prescribed.
- Symptomatic gallbladder disease when fatty foods trigger symptoms.
The degree and type of restriction depend on clinical assessment. These examples do not mean that every patient with these conditions should avoid all fat; adequate energy and essential nutrients remain necessary.
Question 1(e)
Answer
- Fear of illness, procedures or an uncertain outcome.
- Separation from family and familiar surroundings.
- Pain, sleep disturbance and loss of privacy.
- Financial worries or difficulty understanding information.
SECTION B (80 marks)
Answer any FOUR questions in this section.
Question 2(a)
Answer
- Coronary artery disease.
- Stroke caused by cerebrovascular disease.
- Hypertensive heart disease.
- Rheumatic heart disease.
- Peripheral arterial disease.
- Congenital heart disease.
Question 2(b)
Answer
- Type 1: insulin-producing pancreatic cells are destroyed, causing a marked lack of insulin; insulin treatment is required.
- Type 2: the body does not use insulin effectively and may eventually produce insufficient insulin.
- Gestational diabetes: raised blood glucose first recognised during pregnancy that meets gestational diagnostic criteria.
These are the three main categories requested by the paper; other specific forms also exist.
Question 2(c)
Answer
- Shell: clean, intact and without cracks, which protects the contents from contamination.
- Air cell: small when candled, indicating little moisture and gas loss.
- White: thick and firm, with little spreading when the egg is broken onto a flat surface.
- Yolk and smell: yolk is raised and well centred with no unpleasant odour; freshness checks do not replace safe storage and cooking.
Question 3(a)
Answer
- Delay microbial spoilage.
- Slow enzymatic and chemical deterioration.
- Extend usable shelf life.
- Reduce food waste.
- Make seasonal foods available for longer.
- Facilitate storage, transport and a reliable food supply.
Question 3(b)(i)
Answer
- Meat.
- Fish.
- Eggs.
- Milk and milk products.
Question 3(b)(ii)
Answer
- Growth: provide amino acids to build new tissues.
- Repair: replace damaged and worn-out tissue proteins.
- Enzymes: form catalysts that enable metabolic reactions.
- Hormones and signalling: form certain hormones and receptors that regulate body processes.
- Defence: antibodies and other immune proteins help fight infection.
- Transport and balance: proteins carry substances and help maintain fluid and acid–base balance; they may also supply energy when necessary.
Question 4(a)
Answer
- Anorexia nervosa causing prolonged inadequate intake.
- Severe depression associated with persistent loss of appetite.
- Swallowing disorders that prevent adequate intake.
- Digestive obstruction that limits passage of food.
- Malabsorption disorders, such as untreated coeliac disease.
- Prolonged severe diarrhoeal illness that reduces intake and absorption.
Question 4(b)(i)
Answer
HIV means human immunodeficiency virus: a virus that attacks the immune system and, without effective treatment, can progress to AIDS.
Question 4(b)(ii)
Answer
- Fever.
- Sore throat during an early illness.
- Swollen lymph nodes.
- Unexplained weight loss.
- Persistent diarrhoea.
- Persistent cough or recurrent infections in advanced disease.
Symptoms vary by stage and may be absent. These symptoms occur in many illnesses and cannot establish HIV status; appropriate testing is required.
Question 4(c)(i)
Answer
- Gamma radiation.
- Electron-beam radiation.
Both are ionising radiation used in validated industrial sterilisation. Ordinary ultraviolet surface treatment is generally disinfection and should not be assumed to achieve sterilisation.
Question 4(c)(ii)
Answer
Sterilisation eliminates all forms of viable microbial life, including bacterial spores, using a validated process. Disinfection eliminates many or all disease-causing microorganisms on objects, but does not necessarily destroy bacterial spores.
Question 5(a)
Answer
- Hand hygiene: clean hands before and after care and after contact with body fluids or contaminated items.
- Protective precautions: use suitable gloves for body-fluid contact, cover wounds and handle sharps safely.
- Environmental hygiene: clean and, where indicated, disinfect shared surfaces and equipment; manage laundry and waste safely.
- Respiratory and food hygiene: support cough etiquette, suitable ventilation and safe food and water, following any condition-specific care advice.
Question 5(b)
Answer
- Constipation: difficult or infrequent passage of hard stools.
- Diarrhoea: unusually frequent loose or watery stools.
- Haemorrhoids: swollen vascular cushions around the anus or lower rectum that may cause bleeding or discomfort.
- Diverticular disease: pouches in the colon wall that may become inflamed or cause symptoms.
- Ulcerative colitis: chronic inflammatory disease affecting the lining of the colon and rectum.
- Colorectal cancer: malignant growth in the colon or rectum that can alter bowel function and cause bleeding.
Question 6(a)
Answer
- Adjusts nutrient intake to support treatment of a disease.
- Helps prevent or reduce nutrition-related complications.
- Corrects deficiencies and supports recovery.
- Maintains suitable energy intake and quality of life.
Question 6(b)
Answer
Essential amino acids cannot be made by the body in sufficient amounts and must be supplied through food. Non-essential amino acids can normally be synthesised by the body. “Non-essential” does not mean unimportant; some become conditionally essential during illness or growth.
Question 6(c)
Answer
- Bile production: bile supports fat digestion and absorption.
- Carbohydrate regulation: stores glycogen and releases glucose to help maintain blood glucose.
- Protein metabolism: processes amino acids and converts toxic ammonia to urea.
- Protein synthesis: produces albumin and many blood-clotting proteins.
- Fat metabolism: processes fatty acids and produces or handles lipoproteins and cholesterol.
- Storage and detoxification: stores nutrients such as iron and certain vitamins and processes many drugs and harmful substances.
Study references: WHO: diabetes; WHO: HIV and AIDS; CDC: radiation sterilisation. Diet therapy for a patient is planned with a qualified clinician or dietitian.
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