Dept.

of Health and Nutrition Sciences

2900 Bedford Ave. • Brooklyn, NY 11210

HNSC 4241 Clinical Nutrition II

Semester: Fall 2022

Section: MY2, 4 credits
Class time: Mondays and Wednesdays, 2:15-3:55 PM 
Class meeting:   In-person. Room 238 IA
Instructor:    Raghda Alraei, DCN, MS, RD, CDCES
Office hours: Mondays and Wednesdays 4:00-4:30 PM in room 4212 IH, or by appointment
Contact email: ralraei@brooklyn.cuny.edu
Office phone: 718-951-5026

Course Description:

An introduction to the profession and practice of clinical nutrition and dietetics centered on the nutrition
care process: assessment, diagnosis, intervention, monitoring and evaluation. Topics include: screening for
nutritional risk; nutritional assessment and evaluation, dietary care planning; enteral and parenteral
nutrition; counseling theory and methods; ethics of care; reimbursement for medical nutrition therapy.

Prerequisite Courses

HNSC 2210 Human Nutrition (or equivalent), HNSC 2300 Human Physiology (or equivalent); HNSC 3230 Life
Cycle Nutrition (or equivalent), or permission from the chairperson.

Prerequisite or Co-Requisite Courses

HNSC 4240 Clinical Nutrition I

This course contributes to the following ACEND Knowledge requirement (KRDNs)

KRDN 1.3 Apply critical thinking skills
KRDN 2.1 Demonstrate effective and professional oral and written communication and documentation.
KRDN 2.8 Demonstrate an understanding of the importance of and expectations of a professional in
mentoring or precepting others
KRDN 3.1 Use the Nutrition Care Process and clinical workflow elements to assess nutritional parameters
diagnose nutrition problems to make decisions, diagnose nutrition-related problems, and determine and
evaluate nutrition interventions and develop plans to monitor these interventions
KRDN 3.3 Demonstrate counseling and education methods to facilitate behavior change and enhance
wellness for diverse individuals and groups.
KRDN 3.4 Practice routine health screening assessments including measuring blood pressure and
conducting waived point of care lab testing (e.g., glucose, cholesterol)

Spring 2022, HNSC 4241

Course Objectives:

 Conduct basic nutrition screening/assessments based on medical history/physical examination,

dietary assessment, biochemical assessment (laboratory values), anthropometric/body composition
data, and nutrition-focused physical assessment to assess an individual’s dietary intake via dietary
history interview using objective interviewing techniques
 Engage in patient-centered nutrition counseling using verbal skills that encourage patients to clarify
and “own” problems, that guide patients to discover solutions to problems, that enable confronting
patients in an “invitational” style and
 Determine enteral and parenteral nutrition care based on nutritional status of the patient
 Review professional policies and procedures such as documentation of services, third-party
reimbursement, and ethical standards applicable to professional practice

Required Textbooks

Nelms M, Sucher KP, Lacey K, eds. Nutrition Therapy and Pathophysiology. 3rd ed. Boston, MA: Cengage
Learning; 2016. [Note: Available from Brooklyn College online bookstore www.textbookx.com]

Litchford MD. Nutrition Focused Physical Assessment: Making Clinical Connections. Greensboro, NC: Case
Software & Books; 2012. [Note: You can order directly from Case Software & Books (publisher) at
www.casesoftware.com for $59 plus shipping; ISBN 978-1-880989-75-3.]

Recommended Textbook

Bauer KD, Liou D, eds. Nutrition Counseling and Education Skill Development. 3rd ed. Boston, MA: Cengage
Learning; 2016. [Note: Available from Brooklyn College online bookstore www.textbookx.com]

Required reading, additional reading materials, and power point presentations will be posted on Blackboard
before each session.

Grading

Numeric Letter
Score Grade
98 -100 A+
92 – 97 A
90 – 91 A-
86 – 89 B+
82 – 85 B
80 – 81 B-
76 – 79 C+
72 – 75 C
70 – 71 C-

Spring 2022, HNSC 4241

 66 – 69 D+
62 – 65 D
60 – 61 D-
≤59 F

Unless otherwise stated, a curve will not be used.

COURSE EVALUATION/FINAL GRADE

Your final course grade will be comprised of the following components:

Attendance* 4%
Case Studies (4) 16% (4% each)
Diet History Interview 10%
Nutrition Focused Physical Exam Project 10%
Counseling Interview Project 10%
Midterm Exam 25%
Final Exam 25%
Total Grade 100%

* Attendance grade is calculated based on the number of class meeting attended out of total class meetings
(28 meetings). Absences due to religious holidays, medical reasons, or emergency situations will be excused
(if medical or other valid documents are provided). Students are expected to be in class on time. Arriving to
class more than 30 minutes late for two separate days will be considered as one absence.
ASSIGNMENT DETAILS

Assignments include a number of experiential-based activities to develop clinical skills. Written instructions
for each assignment will be discussed in class and will be posted on Blackboard under Assignment tab.
Case Studies: There are several case studies that will give students the skills to apply steps of the nutrition
care process in a variety of conditions including malnutrition, obesity, burns. Students will also have the
chance to practice calculating enteral and parenteral nutrition needs. Due Dates are included in the course
schedule table. (KRDN 1.3, 2.1, 3.1)
Nutrition Focused Physical Exam (NFPE): Students will have a chance to practice some components of the
nutrition focused physical exam and health screening (measuring blood pressure) in class. There will be a
written assignment answering questions about the NFPE. (KRD 3.4)
Diet History Interview: Students will get a hand–on experience with practicing interviewing skills to collect
information about usual dietary intake by making a video and writing a self-assessment. (KRDN 2.1, 3.1)
Nutrition counseling assignment: students will practice using continuing responses in real-life situations.
(KRDN 2.1, 3.3)
Midterm Exam
The exam comprises of multiple choice, true and false and short answer questions. There will be a case study with few questions
and calculations. (KRDN 1.3, 2.1, 2.8, 3.1, 3.4)

Final Exam

Spring 2022, HNSC 4241

The exam comprises of multiple choice, true and false and short answer questions. There will be one or two case studies with
questions and calculations. The final exam will be cumulative. (KRDN 1.3, 2.1, 3.1, 3.4)

COURSE POLICIES

Absences
Absences due to religious holidays, medical reasons, or emergency situations will be excused (if medical or
other valid documents are provided).

Lateness and Early Exits

Students are expected to be in class on time. Arriving to class more than one hour late for two separate
days will be considered as one absence.

Tentative Course Schedule

Date Topic Required Reading
Monday 8/28/22 Overview of the course Ch 1 & 2 in Nutrition Therapy
Introduction to the Nutrition Care Process and Pathophysiology
Wednesday 8/31/22 Medical History and Physical Examination Reading Materials will be
Medical Terminology and Abbreviations posted on Blackboard
Monday 9/5/22 No Class
Wednesday 9/7/22 Anthropometry, Body composition, and Ch 3 in Nutrition Therapy and
Body Fat Distribution Pathophysiology
Monday 9/12/22 Anthropometry, Body Composition, and Ch 3 in Nutrition Therapy and
Body Fat Distribution, cont. Pathophysiology
Wednesday 9/14/22 Biochemical Assessment – Clinical Ch 3 in Nutrition Therapy and
Chemistry Pathophysiology
Monday 9/19/22 Biochemical Assessment – Clinical Ch 3 in Nutrition Therapy and
Chemistry, cont. Pathophysiology
Anthropometric Assessment Case Study
Due
Wednesday 9/21/22 Biochemical Assessment – Hematology Ch 3 in Nutrition Therapy and
Pathophysiology
Monday 9/26/22 No Class
Wednesday 9/28/22 Nutrition Focused Physical Assessment Ch 1,2,3 in Nutrition Focused
Physical Assessment
Thursday 9/29/22 Nutrition Focused Physical Assessment Ch 4, 5, 6 in Nutrition
Biochemical Assessment Case Study Due Focused Physical Assessment
Monday 10/3/22 Dietary Assessment Ch 3 in Nutrition Therapy and
Pathophysiology
Wednesday 10/5/22 No Class
Monday 10/10/22 No Class
Wednesday 10/12/22 Energy, Protein, and Fluid Needs Ch 3 in Nutrition Therapy and
Pathophysiology
Monday 10/17/22 Nutrition Diagnosis Ch 2 in Nutrition Therapy and
Problem, Etiology, signs/symptoms (PES) Pathophysiology

Spring 2022, HNSC 4241

 Statements
Energy and Protein Needs Case Study Due
Wednesday 10/19/22 Nutrition Intervention Ch 4 in Nutrition Therapy and
Pathophysiology

Monday 10/24/22 Midterm

Wednesday 10/26/22 Nutrition Intervention -Goal Setting Ch 4 in Nutrition Therapy and
Nutrition Focused Physical Exam Pathophysiology
Assignment Due
Monday 10/31/22 Behavior Change Theories Ch 4 in Nutrition Therapy and
Pathophysiology

Wednesday 11/2/22 Nutrition Counseling - Verbal Skills – Types Ch 3 in Nutrition Counseling

of Responses] and Education Skill
Dietary History Interview Project Due Development
Monday 11/7/22 Nutrition Counseling – Cognitive Behavior Ch 6 in Nutrition Counseling
Therapy and Education Skill
Development
Wednesday 11/9/22 Nutrition Support - Enteral Nutrition, cont. Ch 5 in Nutrition Therapy and
Pathophysiology
Monday 11/14/22 Nutrition Support – Enteral Nutrition Ch 5 in Nutrition Therapy and
Pathophysiology
Wednesday 11/16/22 Nutrition Support - Parenteral Nutrition Ch 5 in Nutrition Therapy and
Nutrition Counseling Project Due Pathophysiology
Monday 11/21/22 Nutrition Support - Parenteral Nutrition, Ch 5 in Nutrition Therapy and
cont. Pathophysiology
Wednesday 11/23/22 Pharmacology - Drug – Nutrient Interaction Ch 11 in Nutrition Therapy
and Pathophysiology
Monday 11/28/22 Pharmacology - Drug – Nutrient Ch 11 in Nutrition Therapy
Interactions and Pathophysiology
Enteral Nutrition Case Study Due
Wednesday 11/30/22 Pharmacology - Drug – Nutrient Ch 11 in Nutrition Therapy
Interactions and Pathophysiology
Monday 12/5/22 Monitoring and Evaluation Ch 4 & 6 in Nutrition Therapy
and Pathophysiology
Wednesday 12/7/22 Documentation of Services Ch 1 in Nutrition Therapy and
Pathophysiology
Monday 12/12/22 Academy of Nutrition and Dietetics Code of Reading materials will be
Ethics posted on Blackboard
TBA Final Exam

COLLEGE POLICIES
 
Academic Integrity 

Spring 2022, HNSC 4241

The faculty and administration of Brooklyn College support an environment free from cheating and
plagiarism. Each student is responsible for being aware of what constitutes cheating and plagiarism and for
avoiding both.  The complete text of the CUNY Academic Integrity Policy and the Brooklyn College
procedure for implementing that policy can be found at this site:
http://www.brooklyn.cuny.edu/bc/policies  . If a faculty member suspects a violation of academic integrity
and, upon investigation, confirms that violation, or if the student admits the violation, the faculty member
MUST report the violation. NO EXCEPTIONS!  Any violation of the following will result in a grade of 0 for the
assignment or activity. 

Types of Academic Dishonesty Explicitly Prohibited

 Cheating is the unauthorized use or attempted use of material, information, notes, study aides, devices
or communication during an academic exercise.
 Plagiarism is the act of presenting another person’s ideas, research or writings as your own.
 Internet plagiarism includes submitting downloaded term papers or parts of term papers, paraphrasing
or copying information from the internet without citing the source, and “cutting & pasting” from various
sources without proper attribution.
 Obtaining unfair advantage is any activity that intentionally or unintentionally gives a student an unfair
advantage in his/her academic work over another student. This includes sharing specific information
about exam questions with other students. 
 Falsification of records and official documents includes, but is not limited to, forging signatures of
authorization and falsifying information on an official academic record.
 
Center for Student Disability Services 
In order to receive disability-related academic accommodations students must first be registered
with the Center for Student Disability Services (CSDS).  Students who have a documented disability
or suspect they may have a disability are invited to set up an appointment with the Director of the
Center for Student Disability Services, Ms. Valerie Stewart-Lovell at 718-951-5538. If you have
already registered with the CSDS please provide your professor with the course accommodation
form and discuss your specific accommodation with him/her as soon as possible and at an
appropriate time.

Student Absence on Account of Religious Belief 

A student who, for religious reasons, does not attend classes on a particular day or days shall be excused
from any examination or other work.  The student shall have equivalent opportunity to make up any
examination or study or work requirements. Please make every effort to notify me beforehand of any
planned absences for religious reasons.  For a full description of the policy, consult the Brooklyn College
Bulletin.   

Spring 2022, HNSC 4241