Roth 10e NCLEX Chapter 5

MULTIPLE CHOICE 1. The client has been told to consume more omega-3 fatty acids. What food could the nurse say is a good source of omega-3 fatty acids? a. avocado c. oatmeal b. fatty fish d. whole wheat bread ANS: B Omega-3 fatty acids have been reported to help lower the risk of heart disease. Because Omega-3 fatty acids are found in fish oils, an increased intake of fatty fish is recommended. PTS: 1 REF: Polyunsaturated Fats

2. The client has been told to replace saturated fats in the diet with monounsaturated fats and wants to know why. What statement could the nurse make to the client about monounsaturated fats? a. Monounsaturated fats lower the amount of c. Monounsaturated fats raise the amount of high-density lipoprotein in the blood when high-density lipoprotein in the blood when they replace saturated fats in the diet. they replace saturated fats in the diet. b. Monounsaturated fats lower the amount of d. Monounsaturated fats raise the amount of low-density lipoprotein in the blood when low-density lipoprotein in the blood when they replace saturated fats in the diet. they replace saturated fats in the diet.

ANS: B Research indicates that monounsaturated fats lower the amount of low-density lipoprotein (the bad cholesterol) in the blood when they replace saturated fats in the diet. Monounsaturated fats have no effect on HDL. PTS: 1 REF: Monounsaturated Fats

3. The client brings the results of recent cholesterol screening with him to see the nurse. The client is confused about what the results mean and asks what the total cholesterol number should be. Which of the following statements could the nurse make about interpreting the results of the cholesterol screening test? a. Total blood cholesterol should not exceed c. Total cholesterol should not exceed 150 150 mg/dl mg/ml b. Total cholesterol should not exceed 200 d. Total cholesterol should not exceed 200 mg/dl mg/ml ANS: B It is advisable that the total blood cholesterol level should not exceed 200 mg/dl. PTS: 1 REF: Cholesterol

4. A client tells the nurse that he read that low levels of high-density lipoprotein are a risk factor for heart disease. The client wants to know what is considered low. What should the nurse tell the client? a. The level at which low high-density c. The level at which low high-density lipoprotein becomes a major risk factor for lipoprotein becomes a major risk factor for heart disease has been set at 20 mg/dl. heart disease has been set at 40 mg/dl. b. The level at which low high-density d. The level at which low high-density

lipoprotein becomes a major risk factor for heart disease has been set at 30 mg/dl.

lipoprotein becomes a major risk factor for heart disease has been set at 60 mg/dl.

ANS: C The level at which low high-density lipoprotein becomes a major risk factor for heart disease has been set at 40 mg/dl. Research indicates that a high-density lipoprotein level of 60 mg/dl or more is considered protective against heart disease. PTS: 1 REF: Lipoproteins

5. The nurse is teaching a client about planning a balanced diet. What percent of calories from fat of the total daily calorie requirement will the nurse say is needed to prevent deficiency symptoms? a. 10% c. 20% b. 15% d. 30% ANS: A Although no specific dietary requirement for fats is included in the RDA and DRIs, deficiency symptoms do occur when fats provide less than 10% of the total daily calorie requirement. PTS: 1 MULTIPLE RESPONSE 1. The nurse is educating the client about limiting consumption of fat in the diet. The client states that is impossible to limit his/her fat intake further because the client is already trimming all visible fats from the foods he/she consumes. What statements could the nurse make about fats in food? Select all that apply. a. Avoid pastries because they are usually d. Invisible fats are found in meats, cream, high in fat. whole milk, cheese, egg yolk, and nuts. b. Plant foods do not contain fats. e. It is often invisible fats that make it difficult to regulate fat intake. c. Foods contain both fats that are visible and fats that are invisible. f. The client is correct, no further limitation of fats is necessary. REF: Dietary Requirements

ANS: A, C, D, E Fats are present in both animal and plant foods. Fats are sometimes referred to as invisible or visible, depending on their food sources. Invisible fats are those found in foods such as meats, cream, whole milk, cheese, egg yolk, fried foods, pastries, avocados and nuts. It is often invisible fats that make it difficult to regulate fat intake. It is essential that the healthcare professional confirm that clients on limited fat diets are educated about sources of hidden fats. PTS: 1 REF: Food Sources

2. The nurse is teaching a group of clients who recently had cardiac bypass graft surgery about the dietary guidelines they should follow after they are discharged. A client asks what are trans-fats and why must they be limited in the diet? Which of the following statements can the nurse make about trans-fats? Select all that apply. a. Baked goods and foods eaten in d. Trans-fatty acids are a direct cause of restaurants are major sources of trans-fatty cancer. acids . b. If hydrogenated vegetable oil is listed in e. Trans-fatty acids increase triglyceride a products ingredient list, it is likely to levels in the blood.

contain a significant amount of trans-fatty acids. c. Trans-fatty acids are produced during food f. manufacturing of semisolid products, such as margarine.

Trans-fatty acids raise low-density lipoproteins in the blood.

ANS: A, B, C, F Trans-fatty acids are produced when hydrogen atoms are added to monounsaturated or polyunsaturated fats to produce a semisolid product such as margarine and shortening. If hydrogenated vegetable oil is listed in a products ingredient list, it is likely to contain a significant amount of trans-fatty acids. Baked goods and foods eaten in restaurants are major sources of trans-fatty acids. Trans-fatty acids raise low-density lipoproteins and lower total cholesterol. PTS: 1 REF: Trans-Fatty Acids

3. The nurse is teaching a client about lifestyle approaches to reduce serum cholesterol. Which of the following statements could the nurse make about diet and cholesterol? Select all that apply. a. Decrease intake of soluble fiber. d. Reduce intake of monounsaturated fats. b. Exercise helps reduce total serum e. Reduce intake of saturated fats. cholesterol. c. Increase intake of cholesterol. f. Weight loss has no effect on serum cholesterol levels. ANS: B, E A reduction in the amount of total fat, saturated fats, and cholesterol and an increase in the amounts of monounsaturated fats in the diet, weight loss, and exercise all help to lower serum cholesterol levels. Soluble dietary fiber is also considered helpful in lowering blood cholesterol. PTS: 1 REF: Cholesterol

4. The nurse is teaching a class about reducing risk factors for heart disease. When talking about highdensity lipoprotein, the nurse mentions some of the lifestyle habits the clients can adopt to increase the level of high-density lipoproteins in their blood. Select all that apply. a. being slightly overweight d. not smoking b. exercising e. maintaining a desirable weight c. being sedentary f. smoking less than a pack a day ANS: B, D, E Exercising, maintaining a desirable weight, and not smoking are all ways to increase ones highdensity lipoproteins. PTS: 1 REF: Lipoproteins

5. The client asks the nurse if there are any fat substitutes that can be used for baking. Which of the following are fat substitutes that the nurse will say can be used for baking? Select all that apply. a. Aspartame d. Oatrim b. Lecithin e. Simplesse c. Olestra f. Splenda ANS: D Lecithin is a fatty substance that used commercially to make products smooth. Olestra is a fat substitute approved for use only manufacturing of snack foods, Simplesse is a fat substitute that can be used only in cold foods. Oatrim is a fat substitute that can be used in baking, but not frying. Aspartame and Splenda are sugar substitutes.

PTS: 1

REF: Lecithin; Fat Alternatives