NR-228 Nutrition, Health & Wellness - Set 4 - Part 3

Correct Answer: One to two pounds weekly is recommended.

A gradual rate of one to two pounds each week is recommended because gradual losers keep weight off more often, and a five to ten percent reduction already improves blood pressure, glucose and lipids. Option a is incorrect because steep deficits draw energy from muscle as well as fat, lowering basal metabolic rate. Preserving lean tissue requires a moderate deficit combined with resistance activity and adequate protein. Option c is incorrect because that pace demands a daily deficit far beyond what any adult can sustain. Losses of that speed are mostly glycogen, water and lean mass rather than stored fat. Option d is incorrect because severe restriction predicts regain rather than lasting change. Behavioural support, self monitoring and physical activity carry far more evidence for maintenance than the size of the initial cut.

Correct Answer: Begin intravenous fluid and electrolyte replacement

Hyperemesis produces severe dehydration with electrolyte loss and ketonuria. The priority is intravenous fluid and electrolyte replacement, with thiamine given before or with any dextrose to prevent Wernicke encephalopathy. Option b is incorrect because oral intake is the very thing this client cannot tolerate; offering food and drink delays correction of a fluid and electrolyte deficit that is already dangerous. Option c is incorrect because dietitian involvement is valuable later for enteral or oral refeeding planning, but it does nothing about the immediate dehydration and potassium loss driving her presentation. Option d is incorrect because serial weights monitor the problem instead of treating it, and weighing before meal trays assumes she is eating, which the persistent vomiting has already ruled out.

Correct Answer: Season food with herbs, spices, lemon and vinegar

Taste and smell decline with age, and older adults often compensate by over-salting and over-sweetening. Enhancing flavor with herbs, spices, lemon and vinegar restores enjoyment without the sodium load, and zinc status should also be checked. Option a is incorrect because heaping on sugar is the same compensation error as heaping on salt. It displaces nutrient-dense food in a diet that already has fewer calories to spare. Option b is incorrect because keeping salt within reach encourages the very habit causing concern, and a high sodium intake is poorly tolerated by many older adults with hypertension or heart failure. Option d is incorrect because meal temperature is not what has changed. The decline is in the taste and smell receptors themselves, so flavor enhancement helps while a colder tray does nothing at all.

Correct Answer: Record the percentage eaten of each item

A calorie count is recorded item by item, because eating all the gelatin and none of the chicken gives a completely different result from half of everything. The dietitian converts those percentages into calories and protein. Option a is incorrect because a single figure for the whole tray hides which nutrients were actually taken. Two clients who each ate half a tray can have entirely different protein and energy intakes. Option b is incorrect because refusals alone tell the dietitian nothing about what was consumed. The record must include what was offered and what was taken, along with supplements and any food brought in by family. Option c is incorrect because weighing trays is not the method taught for an in-hospital count. Percentages of each item, gathered over three consecutive days, are what the dietitian turns into calories and grams of protein.

Correct Answer: Add 350 calories daily and drink to thirst

Lactation adds about 330 to 400 calories a day above pre-pregnancy needs, and fluid is guided by thirst. Drinking beyond thirst does not raise supply, though dehydration will lower it. Option a is incorrect because 800 calories describes part of the energy cost of milk synthesis, some of which is met from fat stored in pregnancy, not the amount to add to the diet. Option c is incorrect because restricting fluid risks dehydration, which genuinely does reduce milk volume, and 100 calories falls far short of covering the energy demand of producing milk. Option d is incorrect because an addition of that size would promote weight gain rather than the gradual return to pre-pregnancy weight that lactation supports, and forced fluid volumes offer no benefit.

Correct Answer: Complete a dietary assessment and provide counseling

For a client who began pregnancy with obesity, expected gain by twenty weeks is roughly six to nine pounds; eighteen pounds is excessive, so dietary assessment and counseling are indicated. Option b is incorrect because deliberate weight reduction is never appropriate during pregnancy; restricting energy risks ketosis and deprives the fetus of substrate even when the mother is gaining too quickly. Option c is incorrect because her total recommended gain for the whole pregnancy is only 11 to 20 pounds, so she has nearly reached the upper limit with twenty weeks remaining. Option d is incorrect because iron supplementation supports expanding red cell mass and the fetal iron endowment; stopping it would create anemia risk without addressing the pattern of rapid gain.

Correct Answer: Use impedance and rehydrate participants beforehand

Bioelectrical impedance is the practical and most commonly used field method, but readings shift with hydration status. Participants who have just exercised are likely fluid depleted, so rehydration before testing protects the accuracy of the result. Option a is incorrect because hydrostatic weighing is the most accurate technique yet requires a tank, full submersion and a complete exhalation. None of that can be assembled at a community event. Option b is incorrect because the index compares weight with height and reveals nothing about how much of that weight is fat. It ignores lean muscle entirely and cannot substitute for a composition measure. Option c is incorrect because several field techniques travel easily, including skinfold calipers, tape circumferences and impedance analyzers. Cancelling the screening would waste an opportunity to identify participants at cardiometabolic risk.

Correct Answer: Skipping breakfast and more than three meals weekly

The course names behavioral indicators of adolescent nutritional risk: frequently skipping breakfast, eating without family supervision, and skipping more than three meals each week. Behavior, not a number on the scale, identifies the at-risk teenager. Option a is incorrect because milk intake at this age supports the calcium requirement, which peaks at thirteen hundred milligrams daily through adolescence. Low dairy consumption would be the concern, not two daily glasses. Option c is incorrect because a lunch packed at home usually reflects planning and adult involvement, both protective. Frequent fast food and eating away from family supervision are the patterns that raise risk. Option d is incorrect because ordinary school sport participation is healthy activity. Risk arises with sports that emphasize leanness or a low competition weight, where disordered eating and energy deficit become likely.

Correct Answer: Honey is unsafe until twelve months of age

Honey can contain Clostridium botulinum spores, and the infant colon lacks the flora that prevents germination. Infant botulism causes a floppy, weak infant, so honey is withheld until twelve months. Option a is incorrect because starting complementary foods does not change the risk; the protective gut flora develops with age, and the restriction is tied to the first birthday rather than to diet. Option b is incorrect because cooking and baking do not destroy botulinum spores, so honey in baked goods carries the same hazard as honey taken straight from the jar. Option d is incorrect because even a trace on a pacifier can deliver enough spores to germinate in the infant gut; there is no amount considered safe before the first birthday.

Correct Answer: About one tablespoon per year of age

A workable serving guideline for a toddler is about one tablespoon of a food for each year of age. Small portions match the reduced appetite that follows the sharp slowing of growth after infancy. Option b is incorrect because a cup of each food far exceeds what a toddler can eat at one sitting, and heaping the plate invites conflict rather than intake. Offer small amounts and refill on request. Option c is incorrect because adult portions overwhelm a child whose growth velocity and appetite have both fallen since the first birthday. Expecting adult amounts sets up a struggle the parent cannot win. Option d is incorrect because half of a grown person's meal is still more food than a toddler needs, and the guideline uses the child's age rather than a fraction of the adult plate.