The movie makes multiple references to traditional Minnesota food: The Mount Rose High cafeteria serves lutefisk for lunch, Jell-O salad is served at Tammy's funeral, and several scenes include people eating and offering "bars," considered an essential dessert for Minnesota potlucks.
The town of Mount Rose is fictional and is a anagram of Rosemount, where screenwriter Lona Williams graduated from high school. However, all the other Minnesota cities mentioned in the film (such as Burnsville, Forest Lake and Pine City) are real cities in the Minneapolis/St. Paul metropolitan area.
The sports teams at Mount Rose High School are called the "Muskies." This is in reference to the muskellunge, a fish found in northern Minnesota, whose name derives from the Ojibwa word for "ugly pike."
In the hospital scene, when Annette is getting an injection of some kind, the girl giving the injection is dressed as a candy striper, a volunteer position, in no way would a candy striper be doing this. A nurse or a physician's assistant would do this.