RN Nursing · Nutrition · Practice question
A 5' 3" (1. 6 meter) 113 pound (51.3 kg) client has a lipid profile of total cholesterol 267 mg/dL (6.92 mmol/L), LDL 167 mg/dL (4.33 mmol/L), HDL 85 mg/dL (2.2 mmol/L), triglycerides 79 mg/dL (0.89 mmol/L), and VLDL 16 mg/dL (0.41 mmol/L). Based on these findings, it is most important for the nurse to teach the client to make every effort to completely avoid which foods? Reference Range: Total Cholesterol [less than 200 mg/dL (less than 5.2 mmol/L)] LDL [less than 130 mg/dL (less than 3.4 mmol/L)] HDL [greater than 45 mg/dL (greater than 0.75 mmol/L)] VLDL [12 to 30 mg/dL (0.31 to 0.78 mmol/L)] Triglycerides [40 to 160 mg/dL (0.45 to 1.81 mmol/L)]
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Shellfish.
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Nuts.
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✓
Cheese.
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Eggs.
Answer & explanation
Correct: Cheese.
Looking at the lipid profile, the client's total cholesterol is 267 mg/dL (above the desirable level of less than 200 mg/dL), and the LDL is 167 mg/dL (above the target of less than 130 mg/dL). The HDL, VLDL, and triglycerides are all within acceptable ranges. Elevated LDL is primarily driven by dietary saturated fat and cholesterol, and cheese is among the highest sources of saturated fat in the typical diet. Reducing saturated fat intake is the most effective dietary intervention for lowering LDL cholesterol. While eggs contain dietary cholesterol, current evidence shows moderate egg consumption has a smaller effect on LDL than saturated fat does. Nuts are actually beneficial for cardiovascular health, providing unsaturated fats that can help lower LDL. Shellfish contain modest amounts of cholesterol but are low in saturated fat and are not a primary driver of elevated LDL levels. Cheese, particularly full-fat varieties, is dense in saturated fat, which stimulates hepatic LDL receptor downregulation and raises circulating LDL. Since the client's primary abnormality is an elevated LDL in the context of elevated total cholesterol, teaching the client to avoid high-saturated-fat foods like cheese is the most impactful dietary recommendation. The client's normal body weight means the focus should be on food quality rather than caloric restriction.
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