304 Dudek Chapter 4: Lipids

The nurse is seeing a client who prefers to incorporates cheese in most daily meals What can the nurse suggest to this client to help him decrease his fat intake but still use the cheese?

"Choose cheese with 3 grams of fat or less per serving" Diets are effective only if clients follow them. If an item is culturally important, then working with the client and trying to allow that item will increase the success of the diet. Choosing cheese with 3 grams of fat or less per serving is one such option and follows the dietary recommendations.

A client wants to know how to increase his ingestion of "good" cholesterol to improve his health. Which of the following is the nurse's best response?

"You cannot eat more 'good cholesterol' but you can make lifestyle changes" You cannot eat more "good" cholesterol. Lifestyle changes such as quitting smoking, exercising and losing weight will help to increase the amount of good cholesterol in the blood.

The client is questioning the information on a food label of microwave popcorn. The ingredient lists partially hydrogenated oil, yet the label says "zero trans fat." The nurse explains that the food industry can round down to zero even though there truly are trans fats in the product. If the serving size is 1 cup and the total amount in the bag is 3 cups, what is the total trans fat content in this bag?

1.5 grams Amounts of less than 0.5 gram per serving can be rounded down to zero. Eating all 3 cups of popcorn is 3 servings; therefore, 3 cups x 0.5 g/serving = 1.5 g of trans fat per bag of popcorn.

A client is learning how to improve his diet to ensure that he is ingesting all the nutrients he needs. Part of those necessary nutrients is essential fatty acids. The client realizes that his AI of alpha-linolenic acid should be how much?

1.6 grams/day The AI of alpha-linolenic acid for adult men is 1.6 g/day.

The nurse is reviewing a client's food logs. The nurse is concerned that the client might not be ingesting enough linolenic acid. What is the recommended daily AI for linolenic acid for adults?

12 g/day for women, and 17 g/day for men The AI for linolenic acid is 12 g/day for women and 17 g/day for men.

The nurse is calculating a patient's fat intake to note in his record. For lunch, the client consumed 1 cup pasta, 2 oz shrimp, 1 oz low-fat cheese, 1/2 cup chopped celery, and 1/2 cup chopped mung bean sprouts. Approximately how much fat is in this meal?

2-5 grams of fat This meal provides the following: 1 cup pasta (0 to 2 g), 2 oz shrimp (0 to 2 g), 1 oz low-fat cheese (0 to 1 g), 1/2 cup chopped celery (0 g), and 1/2 cup chopped mung bean sprouts (0 g).

The nurse is aware that no AI or RDA has been established for fat consumption. However, the Acceptable Macronutrient Distribution Range is estimated to be which of the following for adults?

20%-35% The AMDR is estimated to be 20% to 35% of total calories for adults.

A client is monitoring her fat intake to help her lose weight. For lunch, this client consumed the following: 1 cup cooked brown rice, 1/2 cup steamed broccoli, 1/2 cup steamed spinach, 1/2 cup steamed carrots, 1/2 cup steamed bean sprouts, 1/2 cup chopped onion, 3 oz salmon fried in 1 tbsp olive oil, and 1 cup green tea. How much fat did the client ingest?

24-26 grams The grams of fat vary among the food choices: 1 cup brown rice (0 to 2 g), 1/2 cup steamed broccoli (0 g), 1/2 cup steamed spinach (0 g), 1/2 cup steamed carrots (0 g), 1/2 cup steamed bean sprouts (0 g), 1/2 cup chopped onion (0 g), 3 oz salmon (9 g) fried in 1 tbsp olive oil (15 g), and 1 cup green tea (0 g). Calculating the various combinations shows that the client will be consuming 24 to 26 grams of fat in this meal.

The nurse is helping a client reduce his fat intake; however, the client is reluctant to give up whole milk. The nurse suggests that the client switch to 2% milk first and later transition to 1% milk. The nurse recognizes that the client will eliminate how many grams of fat per cup of milk by switching from whole milk to 2% milk? Enter the correct number ONLY.

3 There is 8 g fat/cup of whole milk and 5 g fat/cup of 2% milk. Switching will reduce his fat intake by 3 g fat/cup.

Question 4 See full question

3,500 calories Each pound of body fat provides 3,500 calories. These fat reserves can last up to two months.

The nurse knows that meat fat provides approximately how much of the monounsaturated fatty acids in a typical American diet?

50% Meat fat contains moderate amounts of monounsaturated fats, providing approximately 50% of monounsaturated fatty acids in a typical American diet.

The client seeing a nurse states, "Look what I found out! My favorite chips are now 'zero trans fat.I just ate the whole bag!" The nurse notes partially hydrogenated oil on the list of ingredients. The label also indicates that there are 13 servings in this bag. The nurse points out that this bag of chips actually contains approximately how many grams of trans fat?

6.5 g Amounts less than 0.5 g/serving can be rounded down to 0 and the label can claim "zero trans fat." If there are 13 servings, then 13 x 0.5 = 6.5 g of trans fat are in this bag.

The nurse is emphasizing the importance of reading labels when deciding what to eat because the fat content can vary. For example, fat-free milk contains virtually no fat free, while a 1-cup of whole milk has how much fat?

8 grams of fat per cup One cup of whole milk provides 8 grams of fat.

The nurse is discussing fat with a group of high school students. The nurse divides the students into groups and assigns each group to plan a breakfast with the lowest fat content. Which of the following groups is successful in the challenge?

Group 2- 1 cup plain reduced-fat yogurt, 1 cup blueberries, 1 cup black coffee Group 1's meal has 5 to 6 grams of fat [1 cup granola (0 to 1g), 1 medium apple (0 g), 1 cup 2% milk (5 g)]. Group 2's meal has 5 grams of fat [1 cup plain reduced-fat yogurt (5 g), 1 cup blueberries (0 g), 1 cup black coffee (0 g)]. Group 3's meal has 21 to 25 grams of fat [1 fried egg (5 to 6 g), 2 oz pork sausage patty (16 g), 1 cup 1% milk (0 to 3 g)]. Group 4's meal has 10 to 12 grams of fat [2 slices toast (0 to 2 g), 2 tsp butter (10 g), 1 cup hot tea (0 g)].

The health care provider determines that a client's vision changes are associated with a low intake of vitamin A. What should the nurse suggest to the client to increase the absorption of this vitamin?

add carrots to a mix salad with olive oil Vitamin A is a fat-soluble vitamin which means it is absorbed in the body when eaten with a fat during the same meal. Carrots are one source of vitamin A. Adding this vegetable to a salad dressed with olive oil will facilitate the absorption of the vitamin. Bread and margarine are not high sources of vitamin A. Sunlight is used to synthesize vitamin D. Vitamin A supplements would not be absorbed on an empty stomach since fat needs to be present.

The nurse is reviewing the need for fatty acids with a client. The nurse recognizes that which of the following is the most prominent n-3 fatty acid in most Western diets?

alpha-linolenic acid Alpha-linolenic acid is the most prominent n-3 fatty acid in most Western diets. It is found in flaxseed, canola, soybean, and walnuts. Linoleic acid is the essential n-6 fatty acid. Eicosapentaenoic acid and docosahexaenoic acid are n-3 fatty acids that are found in certain fish.

The nurse is working with a client who is a vegan. The client does not want to use supplements to ensure an adequate intake of necessary dietary fats because of the likely animal source of the supplements. Which of the following foods can the nurse recommend to this vegan?

avocados Avocados are considered a fruit; however, the majority of their calories come from fat. Eating half an avocado counts as a serving of fruits and 3 teaspoons of oil.

The nurse reviews care needs for a group of assigned clients. Which client should the nurse identify as being prone to having an alteration in fat metabolism?

client with duodenal ulcer Since most fat digestion occurs in the small intestine the client with a duodenal ulcer is the most prone to having an alteration in fat metabolism. A minimal amount of chemical digestion of fat occurs in the mouth and stomach through the action of lingual lipase and gastric lipases. The clients with a hiatal hernia and gastroesophageal reflux disease are not at a great risk of having an issue with fat metabolism. Even though a small amount of fat is excreted through the feces, the client with diverticulitis is not prone to having an alteration in fat metabolism.

The nurse is aware that fruits are generally fat-free with the exception of a few. Which of the following fruits contain fat? Select all that apply.

coconut avocado olives Avocados, coconut, and olives are fruit that contain oils and fats. Because the overwhelming majority of their calories comes from fat, their fat content counts as part of the oil allowance.

A client is interested in using coconut oil instead of olive oil. What is the nurse's best recommendation to this client?

coconut oil is higher is saturated fats than olive oil Olive oil provides 1 to 2 g saturated fat per tablespoon, and coconut oil can provide 12 g saturated fat per tablespoon.

The majority of trans fats are the result of hydrogenation. The nurse is aware that some trans fats occur naturally in which of the following foods?

dairy product Only small amounts of trans fats occur naturally in some animal foods, such as beef, lamb, and dairy products.

The nurse is helping a client learn how to reduce his cholesterol intake from food. Which of the following has the MOST cholesterol?

egg yolks Egg yolks have approximately 186 mg of cholesterol. Typical cuts of beef, pork, lamb, and poultry generally have around 70 mg of cholesterol/3 ounces. Veal has approximately 90 mg/3 ounces. Egg whites, legumes, and nuts are cholesterol free.

The nurse is seeing a client who is frustrated with a failure to reduce unwanted body fat. The nurse explains fat has which of the following important functions in the body?

fat cushions the organs to protect them from mechanical injury Fat deposits insulate and cushion internal organs to protect them from mechanical injury.

The nurse recognizes that fat is a necessary element for the client to consume and that a client's desire to go fat-free is not a good plan. The nurse explains to the client that the PRIMARY function of fat is which of the following?

fuel the body The primary function of fat is to fuel the body. The other choices are functions of fat but not the primary function.

The nurse understands that triglycerides are composed of several elements. What serves as the backbone of triglycerides?

glycerol Glycerol is a three-carbon chain that serves as the backbone of triglycerides.

The nurse is teaching a nutrition class with some of the clients who are having economic difficulties and unable to choose more expensive cuts of meat to limit fat intake. Which of the following should the nurse recommend that they use?

ground beef that is at least 90% lean Eating lean meats is one way to limit fat intake. Choosing ground beef that is at least 90% lean is recommended.

The nurse is discussing eicosanoids with a group of student nurses. After discussion, the students recognize that eicosanoids derived from EPA to do which of the following?

help to lower blood pressure EPA eicosanoids help to lower blood pressure, prevent blood clot formation, protect against arrhythmias, and reduce inflammation.

To promote good heart health, the nurse knows that the recommended intake of cholesterol is how much?

it is not well defined Daily endogenous cholesterol synthesis is approximately two to three times more than average cholesterol intake. When dietary cholesterol decreases, endogenous cholesterol production increases to maintain an adequate supply. The body makes cholesterol from acetyl-CoA, which can originate from carbohydrates, protein, fat, or alcohol. Thus, eating an excess of calories, regardless of the source, can increase cholesterol synthesis.

The nurse recognizes that phospholipids have a dual solubility:The nurse knows that this means that phospholipids have which of the following characteristics?

keep fats suspended in blood Phospholipids are both fat soluble and water soluble, which enables them to act as emulsifiers. This helps to keep fats suspended in blood and other body fluids.

The nutrition class has been discussing phospholipids. The nurse recognizes that the class has been successful when the students identify which of the following as a phospholipid?

lecithin Lecithin is the best-known phospholipid. The other three choices are common fatty acids that are found in the body.

A client beginning a weight loss program asks the nurse to explain the amount of fat that should be consumed each day since there are no recommendations to be found on the internet. What should the nurse respond to this client?

limit the intake to be between 25-35% of total calories Because there is insufficient data to define a level of total fat intake at which risk of deficiency or prevention of chronic disease occurs, there is not an Adequate Intake (AI) or Recommended Dietary Allowance (RDA) for total fat. An Acceptable Macronutrient Distribution Range (AMDR) for total fat intake is estimated to be 20% to 35% of total calories for adults. Avoiding all fat may be impossible to do since it is present in some degree in a large number of food sources. Also, avoiding all fat can lead to health problems. The client should be encouraged to cut back on fats that are saturated. Fat intake is not variable because it is present in some degree in a large number of foods.

The nurse is seeing a client who is upset that she is not experiencing a more substantial weight loss. The nurse reviews the client's food log and notes that she is limiting her fat intake but not her carbohydrates and protein. What might the nurse suggest that the client should do?

limit total calories, not just fat The Women's Health Initiative Dietary Modification Trial revealed that low-fat diets are no more effective in promoting weight loss than high-fat, low-carbohydrate diets are. The key to managing fat is total calories, not the proportion of calories from carbohydrates, protein, or fat.

The nurse is discussing the structure of fat absorption with a group of students. The nurse explains which of the following deliver fat to the intestinal wall?

micelles Although they are insoluble in water, monoglycerides and long-chain fatty acids dissolve into micelles, which deliver fat to the intestinal cells. Chylomicrons distribute dietary lipids throughout the body. Pancreatic lipase, the most important and powerful lipase, splits off one fatty acid at a time from the triglyceride molecule, working from the outside in until two free fatty acids and a monoglyceride remain. Cholesterol is a sterol, a waxy substance whose carbon, hydrogen, and oxygen molecules are arranged in a ring.

Some fatty acids have double bonds between carbon atoms, preventing them from packing together. Which of the following fatty acids has only one double bond?

monounsaturated fatty acids A monounsaturated fatty acid has only one double bond between two carbon atoms.

The nurse is discussing how to read food labels with a group of students. The nurse explains that which of the following ingredients is an indication the food product contains trans fat?

partially hydrogenated oils Partially hydrogenated oils and foods made with partially hydrogenated oils provide significant amounts of synthetic trans fat.

The nurse recognizes that which of the following makes phospholipids different from triglycerides?

phospholipids have 2 fatty acids and 1 phosphate group attached to the glycerol backbone Phospholipids are different from triglycerides in that a phosphate group replaces one of the fatty acids on the glycerol backbone.

A client has asked the nurse to review his food log to see whether there are any adjustments he can make to help him eliminate more fat from his diet. Which of the following items should the client eliminate? Select all that apply.

polish hot dogs hot dogs bologna Processed foods such as bologna, hot dogs, and Polish sausage have added fats. Chicken and beef are lower in fat.

Corn, soybean, safflower, and cottonseed are all used for oils in the American diet. The nurse recognizes that they provide which of the following fatty acids?

polyunsaturated fatty acids Polyunsaturated fatty acids are the predominant fat in corn, soybean, safflower, and cottonseed oils.

A client is seeing a nurse and asks what is the benefit of hydrogenation. The nurse should respond that this process prevents which of the following?

rancidity If fats are exposed to light and oxygen, over time they will oxidize and undergo chemical change that causes an offensive taste and smell. This is referred to as rancidity.

The nurse is helping a client review his food choices. The nurse notes that this client is consuming a large amount of saturated fat. Which of the following is the client most likely eating?

red meat Saturated fats occur to the greatest extent in animal fats: meats, whole milk, dairy products, and egg yolks.

The nurse reviews actions to help a client reduce the total amount of saturated fat consumed. Which menu choice indicates that the client requires additional teaching?

rib eye steak and green salad with ranch dressing Of the menu choices, the one with the greatest amount of saturated fat is the ribeye steak. This cut of meat has marbleized fat which is solid at room temperature. The Ranch dressing adds additional fat to this menu choice. Additional ways to reduce the amount of saturated fat in the diet includes roasting, grilling, or broiling foods. The turkey and chicken breast could be high in saturated fat if the skin is included in the serving but since this is not identified as being present, the method of preparing is used to determine the amount of saturated fat in the menu selection.

The nurse is aware that the 2015-2020 Dietary Guidelines for Americans recommends 8 oz of seafood per week from a variety of seafood sources. Which of the following are some recommended fish? Select all that apply.

salmon mackerel trout The 2015-2020 Dietary Guidelines for Americans recommend that people without coronary heart disease eat a variety of fish, such as salmon, tuna, mackerel, herring, and trout, about 8 ounces per week.

The nurse prepares nutritional information for a community health fair. Which food item should the nurse highlight that contains the greatest amount of omega-3 fatty acids?

sardines Omega-3 fatty acids are predominantly found in seafood. However not all seafood has this nutrient in high amounts. Of the seafood listed, the greatest amount of omega-3 fatty acid is found in sardines. Crab has the second greatest amount followed by lobster. Shrimp has the least amount of omega-3 fatty acids.

The nurse is helping a client make better food choices. The nurse suggests that the client avoid saturated fats. Which of the following would be a reason for that?

saturated fat is linked to increased intake of LDL Saturated fat is commonly known as "bad" fat. High intake of most saturated fatty acids is linked with high total and LDL cholesterol, which are risk factors for cardiovascular disease.

The nurse is teaching some clients how to prepare foods that are lower in fat to help them improve their family's diets. The nurse suggests which of the following as the BEST option for lower fat content?

skinless chicken breasts Skinless chicken breast has 0 to 1 g fat/ounce. Prime rib has 5 g fat/ounce. Salmon has 3 g fat/ounce. Peanut butter has 8 g fat/ounce.

The nurse is visiting a sixth-grade class to discuss nutrition. After discussing fats with the class, the nurse recognizes that they understand how fats are digested when they identify that most fat digestion occurs where?

small intestine Most fat digestion occurs in the small intestine. A minimal amount of chemical digestion occurs in the mouth and stomach. Fat that moves into the large intestine is usually excreted in the feces.

The nurse is teaching a group of nursing students about the body's need for fuel to function. The class is aware that fat's primary function is to fuel the body. However, which cells are not fueled by fat?

the brain Fat is an important energy source; however, the brain cells and cells of the central nervous system rely solely on glucose for energy.

Unsaturated fatty acids can be classified according to which of the following?

the location of the first double bond from he methyl end Unsaturated fatty acids can be classified according to the location of their double bonds along the carbon chain. The most common method is to count the number of carbon atoms from the methyl end to the first double bond.

The nurse is explaining the difference between the fatty acids to a client. The nurse explains that a common characteristic of saturated fatty acids is that:

they are solid at room temperature Saturated fatty acids are straight-line molecules that can pack tightly together, so they are solid at room temperature.

The nurse is aware that triglycerides are formed with a three-carbon atom glycerol backbone and which of the following?

three fatty acids Structurally, triglycerides are composed of a three-carbon atom glycerol backbone with three fatty acids attached.

The nurse is helping a client pick better choices to decrease solid fat intake. Which of the following are the best choices? Select all that apply.

tuna flax seed walnuts Flaxseed is a good substitute for fat (3 tablespoons of flaxseed = 1 tablespoon fat or oil). Walnuts are rich in monounsaturated fats and contain alpha-linolenic acid. Tuna is a good source of omega-3 fat. Fried foods, processed meats, and pizza can contain solid fat, which should be reduced in the diet.

The nurse is explaining the MyPlate plan to a client who is status post a cholecystectomy and needs to follow a low-fat diet. Which of the following foods are best suited to this client's dietary needs? Select all that apply.

vegetables grain fruit Generally, three MyPlate food groups provide little or no fat. Grains naturally contain very little fat. Unadulterated vegetables contain little or no fat, and fruits (with the exception of avocados, olives, and coconuts) are naturally fat free.

The nurse is discussing the role of fat in the absorption of vitamins. Which of the following are fat soluble vitamins? Select all that apply.

vitamins A, D, E, K Dietary fat facilitates the absorption of the fat-soluble vitamins A, D, E, and K when consumed in the same meal. Vitamin C is a water-soluble vitamin.

A client wants a quick snack that he can just grab and go. Which snack can the nurse recommend that is also a good source of alpha-linolenic acid?

walnuts Walnuts are a rich source of alpha-linolenic acid. They also provide plant protein, fiber, vitamin E, selenium, magnesium, zinc, phosphorus, and potassium in a low-saturated fat, cholesterol-free package.