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DATA GATHERING INSTRUMENT Dear Respondent: This questionnaire is intended to determine the knowledge level of primary caregivers about nutrition. You are in the best position to supply the needed data. In this regard, we would to request you to answer the questions as truthfully and sincerely as possible. Please do not leave any item unanswered. Any information will be treated with utmost confidentiality. Thank you very much. DIRECTION: Please place a check in the column that corresponds to your answer. Do not leave any item unanswered. TRUE if the statement is correct FALSE if the statement is incorrect 1 st PART Food Classification TRUE FALSE 1. Children need less protein in their diet than adults. 2. A low percentage of fats are recommended in the diet of children. 3. Calcium helps in bone strengthening and teeth formation in children. 4. Increase intake in protein rich food will protect the child against infection. 5. Fruits and vegetables are rich in vitamins and minerals. 6. Children need less protein in their diet than adults. 7. Rice is an energy-giving food.

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DATA GATHERING INSTRUMENT

Dear Respondent:

This questionnaire is intended to determine the knowledge level of primary caregivers

about nutrition. You are in the best position to supply the needed data.

In this regard, we would to request you to answer the questions as truthfully and

sincerely as possible. Please do not leave any item unanswered.

Any information will be treated with utmost confidentiality.

Thank you very much.

DIRECTION: Please place a check in the column that corresponds to your answer. Do not leave

any item unanswered.

TRUE if the statement is correct

FALSE if the statement is incorrect

1st

PART Food Classification

TRUE FALSE

1.  Children need less protein in their diet than adults.

2.  A low percentage of fats are recommended in the diet

of children.

3.  Calcium helps in bone strengthening and teeth

formation in children.

4.  Increase intake in protein rich food will protect the child

against infection.

5.  Fruits and vegetables are rich in vitamins and minerals.

6.  Children need less protein in their diet than adults.

7.  Rice is an energy-giving food.

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8.  Grow foods or body-building foods build and repair

body tissues, which enable children to grow and

develop strong muscles and bones.

9.  Vegetables do not increase body resistance to infection

and disease.

10. Carbohydrates or energy-giving foods are obtained

primarily from plant foods.

11. Vitamin content is usually highest in fresh foods that are

consumed quickly after minimal exposure to heat, air or

water.

12.  Legumes such as black-eyed peas, beans, peanut and

chickpeas are sources of plant protein.

13.  Milk, cheese and yogurt are not good sources of 

calcium

14. 14. Starchy foods (rice, pasta, root crops, and bread) arerich in carbohydrates.

15. 15. Green and yellow vegetables, and, deep orange

fruits and vegetables are rich in vitamin B1.

2ND

PART Food Handling and Preparation

TRUE FALSE

1.  Planning meals that contain all the Essential nutrients

is the first step toward a nutritionally adequate dietaryintake.

2.  Cooking can destroy harmful microorganisms in food.

3.  Overcooking of food has no effect on its nutrient value.

4.  Frozen meat must be kept frozen until ready to use.

5.  It is okay not to wash hands during food preparation

because heat from cooking will kill the microorganisms.

6.  Tasting of suspected spoiled food is acceptable.

7.  The way I handle food does not affect my health

outcome.

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8.  Perishable foods can be left out of the refrigerator for

more than 2 hours.

9.  Attention should be focused on vitamin and mineral

losses during food preparation and services.

10. Cook just enough quantity with some safety allowanceto avoid storing any leftovers

11. A nutritious breakfast is a central feature of a childs

diet that supports healthy growth and development.

12. Encourage the child to sit when eating choking is

more likely when children are running or reclining.

13. Always begin food preparation by washing your hands.

Wash your hands with hot soapy water after any

activity in which your hands could have picked up

germs.14. Milk consumption answers the childs requirements for

calcium, protein and the B vitamins nutrients that are

important for a childs growth.

15. Use clean utensils and keep food away from flies and

insects.

3rd PART Common Deficiencies/Problems Related to Nutrition

TRUE FALSE

1.  Insufficient intake of vitamins and minerals can cause

impaired growth and deficiency diseases .

2.  Deficiency in iron can cause anemia.

3.  Vitamin K deficiency can promote hemorrhage.

4.  Vitamin A helps in the prevention of night blindness.

5.  5. Deficiency in Vitamin D cannot cause softening of 

the bones.

6.  Undernutrition is a pathological state resulting from

the consumption of inadequate quantity of food over

an extended period of time.

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7.  Marasmus is mainly due to inadequate calorie intake

and improper feeding practices.

8.  Kwashiorkor is due to proper intake of good quality

proteins.

9.  Anemia occurs because there is deficient proteinintake.

10. Obesity occurs when the energy intake exceeds the

bodys energy requirement for physical activity and

growth resulting to accumulation of fat stored as

adipose tissue.