NR-228 Nutrition, Health & Wellness - Set 2 - Part 1

Correct Answer: They block cholesterol absorption and lower low-density lipoprotein

Plant sterols and stanols compete with cholesterol for a place in the micelles that carry it across the intestinal wall, so absorption falls. About two grams daily lowers low-density lipoprotein by roughly six to twelve percent. Option a is incorrect because the benefit of plant sterols lies on the low-density lipoprotein side of the panel. Nothing in the guidance credits them with raising high-density lipoprotein by any particular amount. Option b is incorrect because bile acids are made in the liver from the body's own cholesterol, not from plant sterols in food. Soluble fiber, not sterols, is what binds bile acids in the gut. Option d is incorrect because the effect is well enough established that two to three grams daily is recommended for dyslipidemia. Dismissing the spread as inert would deny this client a useful measure.

Correct Answer: Baked Atlantic salmon twice each week

Salmon is the canonical source of eicosapentaenoic and docosahexaenoic acid, and the American Heart Association recommends two servings of non-fried fish each week. Baking preserves the benefit that frying would cancel. Option b is incorrect because cod is a lean white fish that carries only small amounts of long-chain omega-3 fat, and frying it cancels the cardiovascular benefit the client is seeking. Option c is incorrect because shellfish such as shrimp supply far less omega-3 fat than the fatty fish do. Shrimp is a reasonable lean protein, but it will not raise this client's omega-3 intake much. Option d is incorrect because canned light tuna delivers less omega-3 fat than canned albacore tuna, and both fall below salmon. Tuna is acceptable, but it is not the strongest choice at the counter.

Correct Answer: The percentage is carbohydrate share of calories

Forty-five to sixty-five percent is the Acceptable Macronutrient Distribution Range, the share of total calories that should come from carbohydrate. The fiber Adequate Intake of twenty-five to thirty-eight grams is a separate and unrelated number. Option a is incorrect because the two values answer different questions and use different units. One is a percentage of energy intake and the other is an absolute weight of fiber, so they cannot be a single target. Option b is incorrect because fruit, milk, legumes and starchy vegetables all deliver carbohydrate and none of them are grains. Restricting either figure to whole grains would leave most of a client's carbohydrate unaccounted for. Option d is incorrect because fiber makes up only a small slice of total carbohydrate. Thirty-eight grams out of roughly three hundred grams is about thirteen percent, nowhere near the range quoted in the study guide.

Correct Answer: A serving of brown rice

Complex carbohydrate means polysaccharide, and brown rice is a grain whose carbohydrate is starch. The distinction rests entirely on chain length, so starches and fibers are complex while single and double sugar units are simple. Option b is incorrect because apple juice delivers the fruit sugar fructose already freed from the fiber matrix of whole fruit. Fructose is a monosaccharide, which places juice firmly in the simple carbohydrate group. Option c is incorrect because honey is composed chiefly of the single sugars fructose and glucose and is counted as an added sugar when it is stirred into food. Nothing about it is a long chain. Option d is incorrect because the carbohydrate in milk is lactose, a disaccharide built from glucose and galactose. Two linked sugar units still count as simple carbohydrate no matter how nutritious the food is.

Correct Answer: Teaching a family about complementary plant protein pairs

Client and family teaching requires assessment of what is already known, judgment about what to say, and evaluation of understanding. Those steps sit with the nurse and cannot be assigned to assistive personnel. Option a is incorrect because preparing a tray is a routine task with a predictable outcome and no clinical decision attached. Assistive personnel do this work every meal on every unit. Option b is incorrect because feeding a client whose swallowing is intact carries no judgment requirement. The picture changes only when swallowing is impaired, and no swallowing difficulty is reported here. Option d is incorrect because measuring intake and output is a standardized observation that assistive personnel perform routinely. The nurse interprets the numbers, but the measuring itself may be assigned.

Correct Answer: Read the indented added sugars line

The Nutrition Facts panel lists total sugars, and directly beneath it an indented line reading includes so many grams added sugars, with its own percent Daily Value. That indented line is the only figure the limit applies to. Option b is incorrect because added sugars are already counted inside the total sugars figure. Summing the two double counts the same grams and would leave the client believing the bar is far worse than it is. Option c is incorrect because fiber is not a sugar and is listed separately under total carbohydrate. Removing it from the sugar figure produces a number that corresponds to nothing on the panel and helps no one. Option d is incorrect because total sugars include naturally occurring sugars such as the fructose in dried fruit as well as anything a manufacturer stirred in. Treating the whole figure as added overstates what the client must limit.

Correct Answer: "I can eat rice at lunch and beans at dinner."

Complementary proteins need to be eaten across the course of the day rather than within one meal, because the amino acid pool holds the amino acids absorbed earlier until synthesis calls for them. Option a is incorrect because the same meal rule is obsolete. A varied plant diet eaten over the whole day with adequate calories supplies every essential amino acid, so the meal timing is unnecessary. Option b is incorrect because spinach is a poor choice to build a protein plan around, and its oxalate also binds calcium so tightly that only a small fraction of the mineral is absorbed. Option d is incorrect because large doses of single amino acids compete with their chemical relatives for shared transporters and can create imbalances. Whole food protein delivers the full pattern in physiologic proportions.

Correct Answer: Carbohydrate and protein enter portal blood; dietary fat enters lymph

Absorbed monosaccharides and amino acids enter the capillaries of the villi and travel by the portal vein to the liver. Long chain fat is packaged into chylomicrons and enters the lymphatic system. Option a is incorrect because long chain fatty acids are rebuilt into triglyceride inside the enterocyte and exported as chylomicrons into the lacteals. They reach the blood at the thoracic duct, bypassing the liver. Option b is incorrect because sugars and amino acids are water soluble and need no lymphatic packaging. Both cross into the villus capillaries and go straight to the liver for first pass handling. Option c is incorrect because it reverses the two routes. Fat is the nutrient that cannot dissolve in plasma and therefore needs the lymph, while the water soluble products take the portal route.

Correct Answer: Ketosis from incomplete oxidation of fatty acids

Without carbohydrate the body lacks the oxaloacetate needed to oxidize fat completely, so the liver condenses surplus acetyl groups into ketone bodies. Acetone is volatile and exhaled, producing the fruity breath odor. Option b is incorrect because insulin falls rather than rises when carbohydrate intake drops, and hypoglycemia produces sweating, shaking and tachycardia from epinephrine rather than a fruity odor on the breath. Option c is incorrect because lactase deficiency presents with bloating, cramping, flatulence and diarrhea within about two hours of a dairy food. Nothing about this presentation points toward undigested milk sugar. Option d is incorrect because impaired bile flow shows itself as steatorrhea, with bulky, greasy, pale stools that float, along with weight loss. Breath odor is not part of that picture.

Correct Answer: Oatmeal topped with sliced apple

Soluble fiber binds bile acids so the liver must draw cholesterol from the blood to replace them, and circulating LDL falls. Oats and apples are named soluble fiber sources, and oatmeal is the canonical answer for cholesterol. Option a is incorrect because wheat bran and brown rice supply insoluble fiber, which adds bulk and speeds transit. Bulk relieves constipation but forms no gel, so it does not carry bile acids out of the gut. Option b is incorrect because eggs and avocado contribute almost no fiber of either type. Avocado does appear on the soluble fiber list, but the portion in a breakfast garnish is far too small to shift a lipid panel. Option d is incorrect because whole wheat is chiefly an insoluble fiber grain and peanut butter is valued for monounsaturated fat rather than viscous fiber. Neither one produces the gel that traps bile acids.

Correct Answer: Antibodies produced by the immune system

Antibodies, complement proteins, cytokines and lymphocyte receptors are all built from amino acids. Protein deficiency lowers lymphocyte numbers and blunts the antibody response, which is why the undernourished client becomes infected repeatedly. Option a is incorrect because bile salts emulsify dietary fat and have no role in resisting respiratory infection. Their loss produces fatty stools and poor absorption of vitamins A, D, E and K. Option b is incorrect because hepatic glycogen is a glucose reserve that maintains blood sugar between meals. It carries no nitrogen and takes no part in recognizing or destroying invading organisms. Option c is incorrect because histamine is an inflammatory mediator released during allergic responses rather than a defense against bacteria. A deficit of it would not explain recurrent chest infections in this client.

Correct Answer: Carbohydrate 45 to 65, fat 20 to 35, protein 10 to 35

The adult acceptable macronutrient distribution ranges are 45 to 65 percent of calories from carbohydrate, 20 to 35 percent from fat, and 10 to 35 percent from protein. All three must be applied together. Option a is incorrect because 25 to 35 percent is the fat range set for children and adolescents aged four through eighteen. An adult is held to the wider lower boundary of 20 percent. Option b is incorrect because the carbohydrate range begins at 45 percent, not 40, and the protein range spans 10 to 35 percent. Narrowing protein to 15 through 30 would wrongly flag an acceptable intake. Option d is incorrect because no authority sets the upper carbohydrate boundary at 70 percent, and capping protein at 30 percent would mislabel a high protein but acceptable pattern as excessive for this client.

Correct Answer: One hundred thirty grams per day

The recommended dietary allowance for carbohydrate is one hundred thirty grams daily for everyone aged one year and older. It is set from the average minimum glucose the brain consumes, with an estimated average requirement of one hundred grams. Option b is incorrect because forty-five grams sits below even the level at which ketosis reliably develops. Classic texts put the minimum that prevents ketosis at fifty to one hundred grams daily, well above this figure. Option c is incorrect because that number is the bottom of the range produced by applying the distribution range to a two thousand calorie diet. It is derived arithmetic for one calorie level, not a reference intake. Option d is incorrect because three hundred twenty-five grams marks the top of that same two thousand calorie calculation. Someone eating fifteen hundred or twenty-eight hundred calories has an entirely different gram range.

Correct Answer: Under two hundred milligrams per deciliter

Desirable total cholesterol is under two hundred milligrams per deciliter. Two hundred to two hundred thirty-nine is borderline high, and two hundred forty or above is classified as high. Option a is incorrect because under one hundred is the optimal value for low-density lipoprotein, not for total cholesterol. Low-density lipoprotein is only one component of the total figure on the report. Option b is incorrect because one hundred fifty is the ceiling for triglycerides, a separate measurement on the same panel. Applying the triglyceride cut point to total cholesterol sets an unreachable target. Option c is incorrect because two hundred forty is where total cholesterol is classified as high rather than desirable. Naming that figure as a goal would reassure a client whose result actually warrants attention.

Correct Answer: "I can use coconut oil freely because it is plant based."

Coconut oil is a tropical oil and is highly saturated despite being plant based, so using it freely would keep this client's saturated fat intake high and undermine the plan. Option a is incorrect because canola oil is the lowest in saturated fat of the common cooking oils, well below lard. Substituting it for lard is exactly what the nurse would want to hear. Option c is incorrect because a tighter limit applies once cardiovascular disease is established. The American Heart Association sets saturated fat below six percent of calories for risk reduction, so this statement is accurate. Option d is incorrect because trimming visible fat and removing poultry skin appear directly on the list of ways to decrease harmful fat. This statement shows the client understood the teaching correctly.

Correct Answer: Sugar alcohols draw water into the bowel

Sugar alcohols are incompletely absorbed, so the remainder stays in the lumen, draws water in osmotically and is fermented by colonic bacteria. The result is gas, bloating, cramping and osmotic diarrhea after a large dose. Option a is incorrect because sugar alcohols are carbohydrates and are declared within total carbohydrate on the label. They supply roughly half the calories of sugar, so a client counting carbohydrate has to account for them. Option b is incorrect because nothing in this picture involves the immune system. An allergic response produces urticaria, wheeze or swelling, whereas these symptoms are purely mechanical consequences of unabsorbed material sitting in the gut. Option d is incorrect because the trouble is slow and incomplete absorption rather than rapid uptake. Polyols that were absorbed quickly would never reach the colon, and it is the portion left behind that produces the symptoms.

Correct Answer: A high-protein oral nutrition supplement

Protein supplies the amino acids fibroblasts use to build collagen, so it is the structural substrate for tissue repair. Vitamins act only as cofactors and cannot compensate for an inadequate protein intake. Option a is incorrect because vitamin C from citrus is a cofactor for the hydroxylases that stabilize collagen, but a cofactor accelerates a reaction that still has nothing to build without protein. Option b is incorrect because broth contributes fluid and sodium with almost no protein or calories. Offering it to a client already losing weight would fill the stomach without meeting the healing demand. Option c is incorrect because bran cereal supplies insoluble fiber for bowel regularity, which is a reasonable goal but unrelated to closing a surgical wound. Fiber provides neither amino acids nor usable energy.

Correct Answer: Read the ingredient list for partially hydrogenated oil

Labeling rules allow a food with less than half a gram of trans fat per serving to declare zero grams. The ingredient list settles it, because partially hydrogenated oil means trans fat is present. Option b is incorrect because the total fat daily value describes quantity rather than type, and trans fat has no daily value at all since no safe intake has been established. It cannot settle this question. Option c is incorrect because serving size matters for totaling intake across several servings, but it says nothing about whether the fat present is trans fat. The client needs to know which oil the manufacturer used. Option d is incorrect because saturated fat and trans fat are separate entries that act differently on the lipid panel, and adding them together still would not reveal whether partially hydrogenated oil was used.

Correct Answer: A bowl of wheat bran cereal

Insoluble fiber holds water in the stool and creates the bulk that distends the colon wall and triggers peristalsis. Wheat bran is the canonical insoluble source, which addresses constipation in a way the morning oatmeal cannot. Option a is incorrect because peeling fruit removes most of its insoluble fiber, and canning softens what remains. The skin of a fruit or root vegetable is where the bulking fiber actually sits. Option b is incorrect because barley is a soluble fiber grain that gels rather than bulks, and straining the soup removes what little solid residue was left. This client already gets soluble fiber from oats. Option c is incorrect because juice has been separated from the pulp and membranes that carried the fiber. Oranges themselves contribute soluble fiber, but the juice contributes sugar and fluid with essentially no fiber at all.

Correct Answer: The calorie and protein deficit that stalls wound healing

An adult with a stage three pressure injury needs generous calories and protein together, because protein burned for fuel cannot build collagen. Inadequate intake stalls healing before the other concerns become measurable. Option a is incorrect because essential fatty acid deficiency develops over sustained very low fat intake and announces itself with dry scaly skin and hair loss. It is a later concern than the energy deficit. Option b is incorrect because poor fluid intake threatens stool consistency and comfort, which matters but does not determine whether the wound closes. The nurse addresses hydration after securing calories and protein. Option d is incorrect because vitamins A, D, E and K are lost when fat is malabsorbed, not merely when a client chooses to eat less of it. This client has no evidence of malabsorption.