NR-228 Nutrition, Health & Wellness - Set 2 - Part 2

Correct Answer: High-density lipoprotein, which runs reverse transport

High-density lipoprotein starts out nearly empty, collects excess cholesterol from peripheral cells and arterial macrophages, and delivers it to the liver for excretion in bile. That return trip is reverse cholesterol transport. Option a is incorrect because low-density lipoprotein travels outward, binding receptors on peripheral cells and depositing cholesterol there. When circulating levels outrun receptor clearance, those particles infiltrate the arterial wall and begin plaque formation. Option c is incorrect because very-low-density lipoprotein leaves the liver carrying triglyceride the liver itself manufactured, and it shrinks into low-density lipoprotein as that triglyceride is stripped away in the capillaries. Option d is incorrect because chylomicrons form in the intestine after a meal and move dietary triglyceride out through the lymph to body cells. They do not retrieve cholesterol from arteries at all.

Correct Answer: Ask about fortified foods or a vitamin B12 source

Vitamin B12 does not occur naturally in plant foods at all, and deficiency causes irreversible neurological damage. A vegan taking no supplement needs a fortified food or a supplement identified without delay. Option b is incorrect because a varied vegan diet with adequate calories typically meets or exceeds protein recommendations. Protein is rarely the nutrient that actually falls short on this pattern. Option c is incorrect because the same meal rule for combining plant proteins has been set aside. Balance across the whole day is what matters, so this question would teach an outdated idea. Option d is incorrect because fiber intake is usually generous on a plant based pattern rather than deficient. Asking about it misses the one nutrient that has no plant source whatsoever.

Correct Answer: Loss of the fat soluble vitamins in the stool

Unabsorbed fat carries vitamins A, D, E and K out in the stool, producing night blindness, bone disease, neuropathy and bleeding. That deficiency, with the energy loss behind the weight change, comes first. Option a is incorrect because soluble fiber and its effect on cholesterol is a long term prevention issue. This client is losing nutrients and weight now, which outranks a lipid concern. Option b is incorrect because nothing in this presentation involves sugar alcohols. Their typical trouble is osmotic diarrhea and bloating from unabsorbed polyol, which is a different mechanism from undigested fat. Option c is incorrect because caries risk rests on how often and how long fermentable carbohydrate sits on the teeth. It is a real concern generally but not what threatens this client now.

Correct Answer: Processing and preparation determine the index

Glycemic index depends on the food and how it is processed and eaten, not on whether the carbohydrate is simple or complex. A baked potato is starch with a high index, while fructose ranks among the lowest. Option a is incorrect because potatoes, white bread, pizza and corn are all starch and all sit in the high index group. Calling every starch slow would send this client toward the very foods she wants to limit. Option c is incorrect because how many sugar units are linked together tells you the classification and nothing more. Viscous fiber, fat, protein, acidity, intact grain structure and gentle cooking all pull the index down. Option d is incorrect because fructose has one of the lowest glycemic indexes of any carbohydrate despite being a single sugar. An apple ranks low, which makes it a better afternoon choice than the potato she substituted.

Correct Answer: Check labels for a phenylalanine warning

Aspartame contains phenylalanine, which accumulates in phenylketonuria and causes irreversible neurological damage. Labels on aspartame-containing products must state that the product contains phenylalanine, so reading the label is what keeps this child safe. Option b is incorrect because sucralose, saccharin, acesulfame potassium, steviol glycosides and monk fruit carry no phenylalanine. Blanket avoidance of sugar-free foods restricts the child needlessly and makes the diet harder to follow. Option c is incorrect because the hazard here is an amino acid, not a polyol. Sorbitol and its relatives cause gas, bloating and osmotic diarrhea in anyone who overeats them, but they pose no specific risk in phenylketonuria. Option d is incorrect because a calorie free claim says nothing about which sweetener was used. Many diet drinks are sweetened with aspartame, and allowing them on that basis would expose the child to the compound she cannot handle.

Correct Answer: Weighing each client and recording the results

Obtaining and recording daily weights is a routine measurement task that unlicensed assistive personnel are trained to perform. Teaching, modifying a plan of care and assessing readiness all require the nurse's judgment. Option a is incorrect because explaining how the minerals in fruits, vegetables and low-fat dairy lower blood pressure is health teaching. Content of that kind belongs to the nurse, who can also answer the questions it raises. Option b is incorrect because changing a prescribed eating plan is outside assistive scope and usually requires the provider or dietitian. The assistant should report the refused tray so the nurse can act on it. Option d is incorrect because judging whether someone is ready to change behavior is an assessment, and assessment is a nursing function. An assistant may report what a client says but cannot interpret it.

Correct Answer: Plant foods contain no cholesterol at all

Cholesterol occurs only in animal foods. Plants make phytosterols instead, so a food of purely plant origin has no cholesterol no matter how much fat it carries. Avocado and peanut butter qualify. Option a is incorrect because avocado and peanut butter are high in monounsaturated fat, not cholesterol. Egg yolk, organ meats, shellfish, meat and full-fat dairy are the foods that actually carry dietary cholesterol. Option c is incorrect because frying adds fat from the cooking oil but cannot create cholesterol in a plant food. Only animal tissue synthesizes cholesterol, so no preparation method changes that fact. Option d is incorrect because fat content and cholesterol content are separate things. Olive oil is nearly pure fat and carries none, while lean organ meat is low in fat yet very high in cholesterol.

Correct Answer: Take a reliable vitamin B12 supplement daily

Vitamin B12 occurs in no plant food, and fermented foods and unfortified yeast are unreliable sources. Deficiency causes irreversible neurologic damage, so a supplement or fortified food is required on a vegan pattern. Option b is incorrect because a varied vegan diet with adequate calories typically meets or exceeds protein recommendations. Protein is the nutrient students expect to be short, yet it rarely is. Option c is incorrect because soy is a complete plant protein and is encouraged rather than avoided. No guideline directs a pregnant client to eliminate tofu, tempeh, edamame or soy milk from the diet. Option d is incorrect because whole grains remain a cornerstone of the pattern despite their phytate content. Soaking, sprouting and leavening degrade phytate, so restriction of grains is unnecessary and nutritionally costly.

Correct Answer: Screening is recommended from age twenty onward

Current cardiology guidance recommends measuring a lipid profile and estimating ten-year atherosclerotic risk beginning at age twenty in adults not already taking lipid-lowering therapy. This client is overdue rather than early. Option a is incorrect because thirty-five is the older screening age for men that newer guidance replaced. Waiting that long would leave more than a decade of modifiable risk unmeasured in a man with this family history. Option b is incorrect because atherosclerosis develops silently for years before angina or infarction appears. Waiting for symptoms forfeits the entire purpose of screening, which is to find risk while it can still be modified. Option c is incorrect because forty-five was the older screening age applied to women, and it was superseded along with the figure used for men. Neither number reflects what current guidance recommends.

Correct Answer: No more than twenty-five grams each day

The American Heart Association sets the ceiling at six teaspoons, or twenty-five grams, of added sugar a day for women and nine teaspoons, or thirty-six grams, for men. The percentage figure belongs to the Dietary Guidelines instead. Option a is incorrect because fifty grams is the reference used to calculate the added sugars percent Daily Value on the label. It represents ten percent of a two thousand calorie diet, not a Heart Association figure. Option b is incorrect because ten grams is the per meal ceiling introduced in the newest edition of the Dietary Guidelines, not a daily total and not a cardiology recommendation. Quoting it here would mislead the client badly. Option d is incorrect because thirty-six grams, or nine teaspoons, is the allowance the same association sets for men. Applying the male figure to a woman would permit roughly half again as much sugar as intended.

Correct Answer: The scoop of green peas

Green peas belong with potato, sweet potato, corn, winter squash and plantain in the starchy vegetable group, so they supply enough carbohydrate to be counted as a serving. Broccoli, green beans, cucumber and celery do not. Option b is incorrect because broccoli sits in the non-starchy group with cauliflower and cabbage. Its carbohydrate content is too small to be counted as a serving, which is why these vegetables are encouraged freely. Option c is incorrect because green beans are classed as non-starchy despite the word bean in the name. True legumes such as kidney beans and lentils are starchy, but the immature pod eaten whole is not. Option d is incorrect because cucumber and celery are mostly water and fiber, and both appear on the course list of non-starchy vegetables. Neither contributes carbohydrate in any amount worth adding to a meal plan.

Correct Answer: "I will use olive oil and broil fish twice weekly."

Olive oil is a monounsaturated fat that lowers LDL when it replaces saturated fat, and two servings of non fried fish each week supply the long chain omega three fatty acids. Option a is incorrect because coconut oil is a tropical oil that is highly saturated despite its plant origin, and frying cancels the cardiovascular benefit that non fried fish would otherwise deliver. Option b is incorrect because stick margarine stays firm precisely because it carries more saturated fat than the soft tub form. A client lowering LDL should choose the soft spread or olive oil instead. Option c is incorrect because palm oil sits near the top of the saturated fat ranking for cooking oils. Trading olive oil for palm oil moves this client in the wrong direction entirely.

Correct Answer: Most blood cholesterol is made by the liver

The liver produces roughly three-quarters of the body's cholesterol, and synthesis is suppressed when dietary intake rises. That feedback is why cutting one cholesterol-containing food changes a serum value far less than expected. Option a is incorrect because one large egg supplies about two hundred milligrams of cholesterol but very little saturated fat. Saturated and trans fat drive the serum value much harder than any cholesterol-containing food does. Option b is incorrect because dietary cholesterol is absorbed, packaged into lipoproteins and handled by the liver rather than deposited directly. Plaque forms when circulating low-density lipoprotein infiltrates and oxidizes within the arterial wall. Option d is incorrect because lipid values respond to a sustained dietary change within weeks, and three months is ample time to see an effect. The problem is the change chosen, not the time allowed.

Correct Answer: Restore adequate protein and add an evening snack

Current hepatic guidance advises against protein restriction in encephalopathy. Cirrhosis needs about 1.2 to 1.5 grams per kilogram daily, and a late evening snack shortens the overnight fast that drives muscle breakdown. Option a is incorrect because continued restriction accelerates the sarcopenia already present. Skeletal muscle converts ammonia to glutamine, so losing muscle removes the tissue that was clearing ammonia and deepens the confusion. Option c is incorrect because a clear liquid diet supplies almost no protein and few calories. A cirrhotic client needs at least thirty-five kilocalories per kilogram daily to avoid breaking down muscle. Option d is incorrect because dairy protein is among the sources best tolerated when meat is not. Vegetable and dairy protein are recommended for clients with encephalopathy rather than being removed from the plate.

Correct Answer: 0.8 gram per kilogram daily

The adult recommended dietary allowance for protein is 0.8 gram per kilogram of body weight each day, which comes to about 56 grams for men and 46 grams for women. Option b is incorrect because milligrams are a thousand times too small a unit for this value. At that intake a seventy kilogram adult would receive less than a mouthful of protein daily. Option c is incorrect because intakes near this level belong to athletes, older adults with illness, or clients healing a pressure injury. A healthy sedentary adult is not in any of those groups. Option d is incorrect because that figure would demand well over five hundred grams of protein daily for a typical adult. No dietary standard approaches it, and the surplus would simply be deaminated.

Correct Answer: Arrange a repeat profile drawn after fasting

A non-fasting profile is acceptable for screening, but when non-fasting triglycerides exceed four hundred milligrams per deciliter the panel should be repeated fasting, because the calculated low-density lipoprotein becomes unreliable. Option a is incorrect because normal triglycerides fall below one hundred fifty milligrams per deciliter, so this result sits in the high band. Recording it as normal would leave a significant abnormality unaddressed. Option b is incorrect because eliminating fat entirely is neither recommended nor safe. Adults need twenty to thirty-five percent of calories from fat, and a near fat-free diet impairs absorption of vitamins A, D, E and K. Option d is incorrect because the high-density lipoprotein result was already within range and is not the abnormal finding. Rechecking a normal value delays attention to the triglyceride elevation that actually needs follow-up.

Correct Answer: "I will add bran cereal and drink less water daily."

Fiber works by holding water, so raising intake without raising fluid produces harder stool, worsened constipation and a risk of impaction. Fluid must rise alongside fiber, and this client has it exactly backward. Option a is incorrect because a gradual increase across one to two weeks is exactly what is taught. Adding fiber slowly lets colonic bacteria adapt and limits the cramping, bloating and gas that follow a sudden jump. Option c is incorrect because the skins of fruits and root vegetables hold most of their insoluble fiber, which is the type that adds bulk and speeds transit. Peeling them would defeat the purpose. Option d is incorrect because pairing extra fluid with extra fiber is the second half of the standard instruction. This statement shows correct understanding and needs praise rather than correction.

Correct Answer: Carbohydrate keeps protein from being burned for glucose

Adequate carbohydrate supplies the glucose the brain and red cells demand, so the liver does not have to make glucose from amino acids. Muscle protein stays intact and remains available for tissue repair. Option a is incorrect because carbohydrate does not reduce how much protein this client needs. A healing surgical wound raises the protein requirement well above baseline regardless of how much carbohydrate is provided. Option b is incorrect because no amount of carbohydrate can build collagen or any other structural tissue. Only amino acids carry the nitrogen that tissue synthesis requires, which is why both nutrients are ordered. Option c is incorrect because glucose cannot be turned into an amino acid without a nitrogen source, and carbohydrate contains none. The traffic runs the other way, from amino acids toward glucose.

Correct Answer: Carbohydrate spares protein for tissue repair

Protein sparing means adequate carbohydrate supplies the glucose the brain and red cells need, so dietary and body protein are not broken down for fuel and remain available for building and repairing tissue. Option a is incorrect because carbohydrate cannot substitute for protein in any structural role. It has no nitrogen, so it cannot build collagen or any other tissue protein, and the protein in the plan is still required. Option b is incorrect because a surgical client's protein requirement rises rather than falls. Carbohydrate protects the protein that is eaten, but the amount of protein needed for wound healing is unchanged by adding it. Option d is incorrect because surplus glucose is stored as glycogen or converted to fat, never into muscle. Building muscle requires amino acids, and the role of carbohydrate here is to keep those amino acids from being burned.

Correct Answer: Ask how many grams of carbohydrate are eaten daily

The grams of carbohydrate eaten determine whether this client is below the level that reliably provokes ketosis and below the recommended minimum. The early weight change is largely glycogen bound water rather than fat. Option b is incorrect because the choice of cooking fat shapes the lipid panel over months, not the sudden loss described here. It is a reasonable later topic but answers nothing about this week. Option c is incorrect because protein portions matter less than the missing carbohydrate. Even a generous protein intake will be deaminated and burned for glucose once carbohydrate falls far enough to force gluconeogenesis. Option d is incorrect because sleep is not what produced a five pound change in three days. Glycogen is stored bound to water, so the scale moves quickly when glycogen stores empty.