Nursing Elites

1. Which condition may benefit from branched chain amino acids (leucine, isoleucine, and valine)?

• A. cancer-related malnutrition
• B. marasmus
• C. cardiovascular disease
• D. severe depression

Correct answer: A

Rationale: Branched chain amino acids, such as leucine, isoleucine, and valine, are essential in preventing muscle breakdown. Therefore, they may be particularly important for a patient with cancer-related malnutrition, where maintaining muscle mass is crucial. Marasmus is a severe form of malnutrition characterized by energy deficiency, not specifically related to cancer. Cardiovascular disease and severe depression do not have a direct correlation with the need for branched chain amino acids to prevent muscle breakdown.

2. Proteins are absorbed primarily in the form of:

• A. fatty acids.
• B. disaccharides.
• C. amino acids.
• D. polypeptides.

Correct answer: C

Rationale: The correct answer is C: amino acids. Proteins are broken down by digestive enzymes into amino acids before being absorbed in the small intestine. Amino acids are the building blocks of proteins and are the form in which they are primarily absorbed. Choice A (fatty acids) is incorrect as fatty acids are the end products of fat digestion, not protein digestion. Choice B (disaccharides) is incorrect because disaccharides are sugars that are broken down into monosaccharides, not proteins. Choice D (polypeptides) is incorrect as proteins are broken down into amino acids and not absorbed as polypeptides.

3. In addition to poor eating habits, a factor that often contributes to marginal nutritional status is:

• A. dependence on caffeine.
• B. acute illness.
• C. low income.
• D. size of the family unit.

Correct answer: C

Rationale: Low income is a significant factor contributing to marginal nutritional status due to limited access to nutritious food. While dependence on caffeine or acute illness can impact health, they are not as directly linked to marginal nutrition as low income. The size of the family unit may affect food distribution within the household but is not as directly related to marginal nutritional status as low income.

4. The type of protein-energy malnutrition that results in edema, hypoalbuminemia, skin lesions, and fatty liver is:

• A. cachexia.
• B. marasmus.
• C. kwashiorkor.
• D. sarcopenia.

Correct answer: C

Rationale: The correct answer is C, kwashiorkor. Kwashiorkor is a type of protein-energy malnutrition characterized by edema, hypoalbuminemia, skin lesions, and fatty liver. Edema is a key feature of kwashiorkor due to hypoalbuminemia, which leads to decreased oncotic pressure. Marasmus (choice B) is a form of severe malnutrition characterized by energy deficiency without significant protein deficiency, resulting in severe wasting. Cachexia (choice A) is a syndrome characterized by weight loss, muscle atrophy, fatigue, weakness, and loss of appetite in someone who is not actively trying to lose weight. Sarcopenia (choice D) is the age-related loss of muscle mass and function.

5. Why are diets that contain less than 10% of kcalories as fat not recommended?

• A. Intake of carbohydrates would not necessarily be too high.
• B. This would not necessarily require excessive use of fat replacers.
• C. The diet would not provide adequate essential fatty acids.
• D. Intake of essential fatty acids would be too low.

Correct answer: D

Rationale: Diets that contain less than 10% of kcalories as fat are not recommended because they would lead to inadequate intake of essential fatty acids, which are crucial for various bodily functions like hormone production, brain function, and cell membrane structure. Option A is incorrect because reducing fat intake does not necessarily mean increasing carbohydrate intake excessively. Option B is incorrect as it introduces a new concept of using fat replacers, which is not directly related to the issue of essential fatty acid intake. Option C is incorrect as the primary concern with low-fat diets is the insufficiency of essential fatty acids, not the adequacy of them.

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