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Question 1Foundations of Sports Nutrition and Macronutrients

Which macronutrient supplies approximately 9 kcal per gram and is the most energy-dense of the three?

  1. Protein
  2. Alcohol
  3. Carbohydrate
  4. Fat Correct answer.

Explanation

Fat yields roughly 9 kcal per gram, compared with about 4 kcal per gram for both protein and carbohydrate. This makes fat the most energy-dense macronutrient, though alcohol at about 7 kcal per gram is not a macronutrient.

Question 2Foundations of Sports Nutrition and Macronutrients

A sports nutritionist wants to calculate the energy contributed by a meal containing 60 g carbohydrate, 30 g protein and 20 g fat. Using standard Atwater factors, what is the total energy?

  1. 550 kcal Correct answer.
  2. 440 kcal
  3. 700 kcal
  4. 620 kcal

Explanation

Applying 4 kcal/g to carbohydrate and protein and 9 kcal/g to fat gives 240 plus 120 plus 180 kcal. The sum is 550 kcal, which is the standard Atwater-based estimate for this meal.

Question 3Foundations of Sports Nutrition and Macronutrients

Which statement best describes the role of dietary protein in athletic adaptation?

  1. It supplies the amino acids used to synthesise and repair muscle and other body proteins. Correct answer.
  2. It is stored in large quantities in adipose tissue as a reserve fuel.
  3. It acts as the primary fuel for sprinting and other short maximal efforts.
  4. It is the main substrate for ATP resynthesis during a marathon.

Explanation

Protein is built from amino acids and provides the building blocks for tissue repair, enzyme and hormone synthesis, and muscle remodelling after training. It is not a major stored fuel or the dominant energy source during most exercise.

Question 4Foundations of Sports Nutrition and Macronutrients

Which form of stored carbohydrate is found primarily in the liver and skeletal muscle?

  1. Cellulose
  2. Fructose
  3. Glycogen Correct answer.
  4. Amylose

Explanation

Glycogen is the branched storage polymer of glucose found in liver and skeletal muscle. Liver glycogen helps maintain blood glucose, while muscle glycogen fuels contraction locally.

Question 5Foundations of Sports Nutrition and Macronutrients

Which statement correctly distinguishes essential from non-essential amino acids?

  1. All amino acids are equally essential and must be supplied by food.
  2. Non-essential amino acids must be obtained from the diet because the body cannot make them.
  3. Essential amino acids cannot be synthesised in sufficient amounts and must come from the diet. Correct answer.
  4. Essential amino acids can be synthesised in adequate amounts by the body.

Explanation

Essential amino acids cannot be produced by the body in amounts sufficient to meet needs, so they must be supplied by dietary protein. Non-essential amino acids can be synthesised endogenously, though some become conditionally essential under stress.

Question 6Foundations of Sports Nutrition and Macronutrients

Which food is the richest source of long-chain omega-3 fatty acids (EPA and DHA)?

  1. Flaxseed oil
  2. Olive oil
  3. Walnuts
  4. Salmon Correct answer.

Explanation

Oily fish such as salmon provide preformed EPA and DHA, the long-chain omega-3 fatty acids. Plant sources like flaxseed and walnuts supply the shorter-chain alpha-linolenic acid, which must be converted, and olive oil is mainly monounsaturated.

Question 7Foundations of Sports Nutrition and Macronutrients

Which statement about dietary fibre is accurate in the context of sports nutrition?

  1. Fibre should be eliminated from all athletes' diets to improve performance.
  2. Fibre is completely digested and absorbed in the small intestine.
  3. Fibre provides about 7 kcal per gram through colonic fermentation.
  4. Fibre slows gastric emptying and can aid satiety but may cause GI discomfort if eaten close to training. Correct answer.

Explanation

Fibre is largely indigestible but affects gastric emptying and satiety, which can be helpful for weight management yet problematic before hard sessions. Fermentation yields some short-chain fatty acids, but fibre is not a meaningful direct energy source.

Question 8Foundations of Sports Nutrition and Macronutrients

Which macronutrient is the predominant fuel for a 100 m sprint lasting about 10 seconds?

  1. Fat
  2. Dietary fibre
  3. Stored phosphocreatine and muscle glycogen Correct answer.
  4. Protein

Explanation

Very short maximal efforts rely on the immediate phosphagen system and rapid glycolysis from muscle glycogen. Fat oxidation is too slow and protein contributes negligibly to such brief maximal bursts.

Question 9Foundations of Sports Nutrition and Macronutrients

An endurance athlete weighing 70 kg aims for a carbohydrate intake of 8 g/kg per day during heavy training. How many grams of carbohydrate does this represent?

  1. 630 g
  2. 700 g
  3. 420 g
  4. 560 g Correct answer.

Explanation

Multiplying 8 g/kg by 70 kg gives 560 g of carbohydrate per day. This falls within common recommendations for athletes with high training loads preparing for endurance events.

Question 10Foundations of Sports Nutrition and Macronutrients

Which protein intake best reflects general sports nutrition guidance for most strength athletes aiming to build muscle?

  1. 1.6 to 2.0 g/kg per day Correct answer.
  2. 0.4 g/kg per day
  3. 0.8 g/kg per day
  4. 3.5 to 4.0 g/kg per day

Explanation

A daily protein intake of roughly 1.6 to 2.0 g/kg body mass is widely supported for resistance-trained athletes seeking muscle gain. Higher intakes offer little additional benefit for most, and very low intakes risk negative nitrogen balance.

Question 11Foundations of Sports Nutrition and Macronutrients

Which change to a pre-exercise meal is most likely to reduce gastrointestinal distress before a long run?

  1. Increasing fat and fibre content to slow digestion
  2. Choosing low-fibre, easily digested carbohydrate close to the start Correct answer.
  3. Adding a large serving of legumes 30 minutes before the run
  4. Consuming a high-protein steak immediately before the run

Explanation

Low-fibre, easily digested carbohydrate empties from the stomach quickly and limits gut discomfort before endurance exercise. High-fat, high-fibre or high-protein foods slow gastric emptying and increase the risk of GI symptoms.

Question 12Foundations of Sports Nutrition and Macronutrients

Which statement about the thermic effect of food is correct?

  1. Fat has the highest thermic effect of the three macronutrients.
  2. Protein has the highest thermic effect, estimated at roughly 20 to 30 percent of its energy. Correct answer.
  3. The thermic effect of food accounts for most daily energy expenditure.
  4. Carbohydrate's thermic effect exceeds that of protein.

Explanation

Protein requires the most energy to digest and metabolise, with a thermic effect of roughly 20 to 30 percent of its energy content. Fat has the lowest thermic effect, and total thermic effect is a modest share of daily energy expenditure.

Question 13Foundations of Sports Nutrition and Macronutrients

Why is consuming carbohydrate during exercise lasting longer than about 90 minutes beneficial?

  1. It replaces the need for post-exercise protein intake.
  2. It delivers exogenous glucose that spares liver glycogen and supports blood glucose. Correct answer.
  3. It prevents all muscle glycogen depletion for the entire event.
  4. It increases fat oxidation to the point that glycogen is no longer used.

Explanation

Carbohydrate feeding during prolonged exercise provides exogenous glucose, helping maintain blood glucose and sparing liver glycogen. It cannot fully prevent muscle glycogen depletion, but it can delay fatigue and support performance.

Question 14Foundations of Sports Nutrition and Macronutrients

Which statement best describes the concept of protein quality?

  1. It refers only to the total grams of protein consumed in a day.
  2. It is determined by the carbohydrate content of the protein food.
  3. It reflects the amino acid profile and digestibility of a protein source. Correct answer.
  4. It depends exclusively on the fat content of the food.

Explanation

Protein quality reflects how well a protein supplies essential amino acids and how digestible it is. Animal proteins generally score higher, while plant proteins can be combined to provide complementary amino acid profiles.

Question 15Foundations of Sports Nutrition and Macronutrients

Which scenario best illustrates glycogen supercompensation?

  1. An athlete consumes only fat for three days before an event.
  2. An athlete reduces carbohydrate intake for a week before competition.
  3. An athlete avoids all carbohydrate during a marathon.
  4. An athlete depletes glycogen then increases carbohydrate intake to elevate muscle glycogen above normal. Correct answer.

Explanation

Glycogen supercompensation involves depletion followed by high carbohydrate intake to raise muscle glycogen above usual resting concentrations. This can support endurance performance, though simplified modern protocols are often used.

Question 16Foundations of Sports Nutrition and Macronutrients

Which fatty acid is classified as essential in the human diet?

  1. Stearic acid
  2. Alpha-linolenic acid Correct answer.
  3. Palmitic acid
  4. Oleic acid

Explanation

Alpha-linolenic acid is an omega-3 essential fatty acid because humans lack the enzymes to introduce double bonds beyond the ninth carbon. Linoleic acid is the other essential fatty acid, while oleic, palmitic and stearic acids can be synthesised.

Question 17Foundations of Sports Nutrition and Macronutrients

A vegetarian athlete wants to improve the amino acid profile of a plant-based meal. Which strategy is most appropriate?

  1. Consuming only fruit before training
  2. Relying solely on a single low-protein vegetable
  3. Avoiding all legumes to reduce fibre intake
  4. Combining complementary plant proteins such as rice and beans Correct answer.

Explanation

Combining complementary plant proteins, such as grains with legumes, supplies a fuller essential amino acid profile. This approach supports protein synthesis for vegetarian athletes without requiring animal foods.

Question 18Foundations of Sports Nutrition and Macronutrients

Which statement about the role of carbohydrate in central nervous system function is accurate?

  1. The brain relies heavily on glucose and can be affected when blood glucose falls. Correct answer.
  2. The brain uses fat directly as its main fuel at all times.
  3. Brain glucose use is unrelated to dietary carbohydrate.
  4. The brain does not require glucose under any circumstances.

Explanation

The brain depends largely on glucose and is sensitive to low blood glucose, which can impair concentration and coordination. During prolonged fasting, ketones can partially substitute, but glucose remains the primary fuel in normal conditions.

Question 19Foundations of Sports Nutrition and Macronutrients

Which statement best explains why fat is an important fuel during low- to moderate-intensity endurance exercise?

  1. Fat cannot be oxidised by skeletal muscle.
  2. Fat oxidation is very fast and dominates during maximal sprints.
  3. Fat provides a large energy reserve and its oxidation becomes proportionally greater as intensity falls. Correct answer.
  4. Fat oxidation requires no oxygen.

Explanation

Body fat represents a large energy reserve, and its contribution rises as exercise intensity decreases and duration increases. Fat oxidation is aerobic and relatively slow, so it dominates low- to moderate-intensity work rather than sprints.

Question 20Foundations of Sports Nutrition and Macronutrients

Which dietary change is most consistent with reducing saturated fat intake while maintaining energy needs for an athlete?

  1. Replacing butter and fatty meats with olive oil, nuts and fish Correct answer.
  2. Removing all fat from the diet
  3. Increasing fried food and processed meat intake
  4. Adding more butter to every meal

Explanation

Substituting unsaturated fat sources such as olive oil, nuts and fish for saturated fats improves the fatty acid profile while still meeting energy needs. Removing all fat would compromise essential fatty acid and fat-soluble vitamin intake.

Question 21Foundations of Sports Nutrition and Macronutrients

Which statement accurately describes the relationship between protein timing and muscle protein synthesis?

  1. Protein must be consumed within a few seconds of training to have any effect.
  2. Distributing protein in moderate doses across the day supports repeated stimulation of muscle protein synthesis. Correct answer.
  3. Protein timing is irrelevant to muscle adaptation.
  4. Only protein consumed before sleep is used for muscle repair.

Explanation

Muscle protein synthesis is stimulated by amino acid availability, and spreading moderate protein doses across meals supports repeated stimulation. The narrow 'anabolic window' is less critical than total daily intake, but timing still contributes.

Question 22Foundations of Sports Nutrition and Macronutrients

An athlete follows a very low-carbohydrate ketogenic diet for several weeks. Which adaptation is most likely to occur?

  1. Complete elimination of the need for protein
  2. Immediate increase in maximal sprint power
  3. Increased reliance on ketone bodies and fat oxidation with reduced muscle glycogen availability Correct answer.
  4. Higher muscle glycogen stores than a high-carbohydrate diet

Explanation

Sustained carbohydrate restriction increases fat oxidation and ketone production while lowering muscle glycogen availability. This can impair high-intensity performance even if some endurance capacity adapts.

Question 23Foundations of Sports Nutrition and Macronutrients

Which explanation best accounts for the higher energy cost of storing dietary fat compared with storing dietary carbohydrate?

  1. Fat is stored with relatively little conversion, whereas carbohydrate must first be converted to glycogen or fat at a greater energy cost. Correct answer.
  2. Fat storage requires more ATP because fatty acids are converted to glucose first.
  3. Fat cannot be stored in adipose tissue.
  4. Carbohydrate is stored with no energy cost at all.

Explanation

Dietary fat is deposited in adipose tissue with relatively little metabolic conversion, so its storage cost is low. Carbohydrate must be converted to glycogen or, when in excess, to fat, which requires more energy and explains part of the difference.

Question 24Foundations of Sports Nutrition and Macronutrients

An endurance athlete reports fatigue, poor recovery and frequent illness during high-volume training. Which nutritional assessment is most relevant first?

  1. Assuming the issue is unrelated to diet and adding supplements immediately
  2. Checking whether energy intake matches training expenditure and carbohydrate availability is adequate Correct answer.
  3. Increasing protein to 5 g/kg per day without assessing energy intake
  4. Eliminating carbohydrate to promote fat adaptation

Explanation

Chronic fatigue and illness in high-volume training often reflect low energy availability and inadequate carbohydrate, which impair recovery and immune function. Assessing energy balance and carbohydrate intake is a logical first step before considering supplements.

Question 25Foundations of Sports Nutrition and Macronutrients

Which statement best explains why carbohydrate intake should be individualised for an athlete rather than set at a single universal value?

  1. Carbohydrate has no effect on training adaptation.
  2. All athletes require exactly the same carbohydrate intake regardless of sport.
  3. Carbohydrate needs vary with training volume, intensity, body size and performance goals. Correct answer.
  4. Fat intake always replaces carbohydrate needs.

Explanation

Carbohydrate requirements depend on factors such as training load, intensity, body mass and goals, so guidelines are expressed as ranges. Individualising intake helps match glycogen needs while supporting overall energy balance.

Question 26Foundations of Sports Nutrition and Macronutrients

Which energy system is the primary contributor to ATP production during a maximal-effort 400 m sprint lasting approximately 50 seconds?

  1. Fatty acid oxidation
  2. Anaerobic glycolysis Correct answer.
  3. The ATP-PCr system
  4. Oxidative phosphorylation

Explanation

A 400 m sprint lasting about 50 seconds relies predominantly on anaerobic glycolysis, which breaks down glucose to lactate and produces ATP rapidly without oxygen. The ATP-PCr system contributes but is depleted within about 10 seconds, while oxidative phosphorylation becomes more important only as effort duration increases beyond about 2 minutes.

Question 27Foundations of Sports Nutrition and Macronutrients

Which statement accurately describes the role of carbohydrate loading for an endurance athlete preparing for a marathon?

  1. It primarily increases liver glycogen, which is the main fuel source during the later stages of a marathon.
  2. It is only beneficial for athletes competing in events lasting less than 60 minutes.
  3. It should be implemented by consuming a very high fat diet in the final 3 days before the race.
  4. It increases muscle glycogen stores above normal resting levels when combined with taper and adequate carbohydrate intake. Correct answer.

Explanation

Carbohydrate loading, typically achieved by tapering training while increasing carbohydrate intake to about 8–12 g/kg/day in the final 2–3 days, can elevate muscle glycogen stores above normal. This is beneficial for endurance events lasting longer than about 90 minutes, as higher initial glycogen delays fatigue.

Question 28Foundations of Sports Nutrition and Macronutrients

An athlete weighing 70 kg wants to estimate his daily protein needs for muscle repair during a period of intense strength training. Using the general sports nutrition recommendation of 1.6–2.0 g/kg/day, what is the appropriate daily protein intake range?

  1. 168–210 g
  2. 84–98 g
  3. 112–140 g Correct answer.
  4. 56–70 g

Explanation

Multiplying body mass (70 kg) by the recommended range of 1.6–2.0 g/kg/day yields 112–140 g of protein per day. This range supports muscle protein synthesis and repair in strength-trained athletes.

Question 29Foundations of Sports Nutrition and Macronutrients

Which statement best explains why athletes are advised to consume carbohydrate in the hours before endurance exercise?

  1. It directly increases fat oxidation during exercise, sparing muscle glycogen.
  2. It reduces the reliance on the ATP-PCr system during high-intensity efforts.
  3. It increases muscle glycogen stores and helps maintain blood glucose during the early stages of exercise. Correct answer.
  4. It enhances protein synthesis during the post-exercise recovery period.

Explanation

Pre-exercise carbohydrate intake tops up liver glycogen and can increase muscle glycogen, helping to maintain blood glucose and delay fatigue during endurance exercise. It does not primarily increase fat oxidation or affect the ATP-PCr system, and protein synthesis is a separate recovery process.

Question 30Foundations of Sports Nutrition and Macronutrients

A 65 kg endurance athlete follows a high-carbohydrate diet providing 10 g/kg/day. During a 3-hour training session, she consumes 90 g of carbohydrate from sports drinks and gels. If her total daily energy intake is 3,500 kcal, what approximate percentage of her daily carbohydrate intake is consumed during the session?

  1. About 25%
  2. About 40%
  3. About 7%
  4. About 14% Correct answer.

Explanation

Daily carbohydrate intake is 65 kg × 10 g/kg = 650 g. The 90 g consumed during training represents 90 ÷ 650 ≈ 0.138, or about 14% of daily carbohydrate intake. This illustrates that even substantial during-exercise intake is a small fraction of a high-carbohydrate daily plan.

Question 31Micronutrients, Hydration, and Electrolytes

Which mineral is the central atom in the cobalamin structure of vitamin B12?

  1. Iron
  2. Zinc
  3. Cobalt Correct answer.
  4. Molybdenum

Explanation

Vitamin B12 is a corrinoid compound whose ring system chelates a single cobalt atom at its center. Iron, zinc, and molybdenum serve other metalloenzyme roles but are not part of cobalamin.

Question 32Micronutrients, Hydration, and Electrolytes

Which vitamin functions as the primary antioxidant that regenerates vitamin E in cell membranes?

  1. Biotin
  2. Vitamin C Correct answer.
  3. Thiamin
  4. Vitamin K

Explanation

Ascorbate donates electrons to reduce the tocopheroxyl radical back to active vitamin E, helping protect membrane lipids from oxidation. Thiamin, biotin, and vitamin K have unrelated coenzyme roles.

Question 33Micronutrients, Hydration, and Electrolytes

Which electrolyte is the principal intracellular cation that drives the resting membrane potential?

  1. Sodium
  2. Potassium Correct answer.
  3. Chloride
  4. Calcium

Explanation

Potassium is concentrated inside cells, and its gradient across the membrane largely sets the resting membrane potential. Sodium and chloride are mainly extracellular, and calcium is mostly stored or bound.

Question 34Micronutrients, Hydration, and Electrolytes

Which trace mineral is required for the synthesis of thyroid hormones by thyroid peroxidase?

  1. Iodine Correct answer.
  2. Chromium
  3. Selenium
  4. Copper

Explanation

Thyroid peroxidase incorporates iodine onto tyrosine residues to form T3 and T4, so iodine deficiency impairs hormone synthesis. Selenium supports deiodinase activity but is not the atom added to tyrosine.

Question 35Micronutrients, Hydration, and Electrolytes

Which vitamin deficiency classically presents with night blindness due to impaired rhodopsin formation?

  1. Vitamin E
  2. Vitamin B6
  3. Vitamin D
  4. Vitamin A Correct answer.

Explanation

Retinal is the chromophore of rhodopsin, so inadequate vitamin A impairs rod function and causes night blindness. The other listed vitamins are not required for phototransduction.

Question 36Micronutrients, Hydration, and Electrolytes

Which statement best describes the recommended approach to fluid replacement during prolonged endurance exercise?

  1. Drink to thirst and avoid gaining weight during exercise Correct answer.
  2. Drink to a fixed volume regardless of thirst
  3. Drink beyond thirst to prevent any weight loss
  4. Restrict all fluids until the event ends

Explanation

Guidance emphasizes drinking to thirst and limiting fluid intake so body mass does not rise during exercise, which reduces the risk of dilutional hyponatremia. Fixed high-volume schedules can overshoot losses.

Question 37Micronutrients, Hydration, and Electrolytes

Which mineral is the cofactor for the enzyme superoxide dismutase that acts in the mitochondrial matrix?

  1. Fluoride
  2. Manganese Correct answer.
  3. Iodine
  4. Cobalt

Explanation

Manganese superoxide dismutase (SOD2) neutralizes superoxide radicals inside mitochondria. Iodine, fluoride, and cobalt have distinct roles and do not form this antioxidant enzyme.

Question 38Micronutrients, Hydration, and Electrolytes

A marathon runner loses about 1.5 L of sweat containing roughly 40 mmol/L sodium. Which change in extracellular fluid is most likely before any fluid is replaced?

  1. Decreased serum sodium
  2. Decreased plasma osmolality
  3. Increased plasma volume
  4. Increased plasma osmolality Correct answer.

Explanation

Sweat is hypotonic relative to plasma, so losing it concentrates the extracellular fluid and raises osmolality while reducing volume. Sodium concentration therefore tends to rise rather than fall.

Question 39Micronutrients, Hydration, and Electrolytes

A patient with chronic kidney disease has a serum potassium of 6.2 mmol/L. Which dietary adjustment is most appropriate?

  1. Increase intake of potatoes and tomatoes
  2. Increase intake of salt substitutes
  3. Reduce intake of high-potassium foods Correct answer.
  4. Increase intake of bananas and oranges

Explanation

Hyperkalemia in kidney disease is managed partly by limiting high-potassium foods such as bananas, potatoes, and tomatoes. Many salt substitutes are potassium chloride and would worsen the elevation.

Question 40Micronutrients, Hydration, and Electrolytes

Which combination best explains why thiamin deficiency causes lactic acidosis in chronic alcohol use?

  1. Thiamin blocks pyruvate dehydrogenase
  2. Thiamin is a cofactor for pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase Correct answer.
  3. Thiamin is required for fatty acid beta-oxidation
  4. Thiamin inhibits lactate dehydrogenase directly

Explanation

Thiamin pyrophosphate is required by pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase, so deficiency impairs entry of pyruvate into the TCA cycle and shifts metabolism toward lactate. It does not inhibit these enzymes.

Question 41Micronutrients, Hydration, and Electrolytes

A vegan client asks which nutrient combination improves non-heme iron absorption from a lentil meal.

  1. Calcium-rich dairy with the meal
  2. Phytate-rich bran with the meal
  3. Vitamin C-rich food with the meal Correct answer.
  4. Tea consumed with the meal

Explanation

Ascorbic acid reduces ferric iron to the more absorbable ferrous form and forms soluble chelates, enhancing non-heme iron uptake. Calcium, polyphenols in tea, and phytates inhibit absorption.

Question 42Micronutrients, Hydration, and Electrolytes

Which laboratory finding is most consistent with prolonged excessive water intake without electrolyte replacement?

  1. Hypercalcemia with shortened QT interval
  2. Hyperkalemia with metabolic acidosis
  3. Hypernatremia with high osmolality
  4. Hyponatremia with low osmolality Correct answer.

Explanation

Excess free water dilutes plasma sodium, producing hypotonic hyponatremia. Sodium and osmolality fall rather than rise, and potassium and calcium are not the primary derangement.

Question 43Micronutrients, Hydration, and Electrolytes

Which vitamin is synthesized in the skin from 7-dehydrocholesterol after ultraviolet B exposure?

  1. Vitamin B12
  2. Vitamin D3 Correct answer.
  3. Vitamin K2
  4. Vitamin A

Explanation

UVB converts 7-dehydrocholesterol to previtamin D3, which isomerizes to cholecalciferol. The other vitamins are obtained from diet or gut flora and are not photochemically produced in skin.

Question 44Micronutrients, Hydration, and Electrolytes

A patient on furosemide develops muscle weakness and a flattened T wave with prominent U waves on ECG. Which electrolyte deficit is most likely?

  1. Hypochloremia
  2. Hyperkalemia
  3. Hypernatremia
  4. Hypokalemia Correct answer.

Explanation

Loop diuretics increase renal potassium loss, and hypokalemia produces weakness with flattened T waves and U waves. Hyperkalemia instead causes peaked T waves and a widened QRS.

Question 45Micronutrients, Hydration, and Electrolytes

Which nutrient acts as a cofactor for the carboxylation of glutamate residues in clotting factors II, VII, IX, and X?

  1. Folate
  2. Niacin
  3. Vitamin C
  4. Vitamin K Correct answer.

Explanation

Vitamin K is the cofactor for gamma-glutamyl carboxylase, which activates these clotting factors. Vitamin C, folate, and niacin serve other metabolic functions.

Question 46Micronutrients, Hydration, and Electrolytes

Which dietary factor most increases calcium absorption in a client with adequate vitamin D status?

  1. Lactose in dairy foods Correct answer.
  2. Excess dietary fiber
  3. Phytates in whole grains
  4. Oxalates in spinach

Explanation

Lactose and the overall food matrix of dairy products enhance calcium bioavailability, while oxalates, phytates, and excess fiber bind calcium and reduce absorption.

Question 47Micronutrients, Hydration, and Electrolytes

A client reports consuming a high-sodium diet and wants to reduce blood pressure through nutrition. Which change is most directly supported?

  1. Increase potassium-rich fruits and vegetables Correct answer.
  2. Increase sodium-containing sports drinks
  3. Increase processed meat intake
  4. Decrease dietary calcium intake

Explanation

Higher potassium intake from fruits and vegetables promotes sodium excretion and helps lower blood pressure alongside sodium reduction. Increasing processed meats or sodium drinks would raise sodium load.

Question 48Micronutrients, Hydration, and Electrolytes

Which mineral deficiency is most strongly associated with impaired wound healing and loss of taste acuity?

  1. Manganese
  2. Zinc Correct answer.
  3. Selenium
  4. Fluoride

Explanation

Zinc supports epithelial repair, immune function, and taste perception, so deficiency can delay wound healing and blunt taste. Selenium, manganese, and fluoride do not have this classic presentation.

Question 49Micronutrients, Hydration, and Electrolytes

A client with a history of calcium oxalate kidney stones asks about vitamin C supplementation. Which response is most appropriate?

  1. High-dose vitamin C is safe because it is water soluble
  2. Vitamin C has no relationship to oxalate metabolism
  3. Vitamin C prevents oxalate stone formation
  4. High-dose vitamin C may increase oxalate excretion Correct answer.

Explanation

A portion of absorbed ascorbate is metabolized to oxalate, so very high intakes can raise urinary oxalate and stone risk in susceptible people. Water-soluble excess is still excreted, but the oxalate pathway matters.

Question 50Micronutrients, Hydration, and Electrolytes

Which electrolyte disturbance most directly impairs neuromuscular transmission by reducing the depolarizing sodium current?

  1. Hyperchloremia
  2. Hypercalcemia Correct answer.
  3. Hyperkalemia
  4. Hypernatremia

Explanation

Elevated extracellular calcium raises the threshold for sodium channel activation, reducing excitability and causing weakness and hyporeflexia. Potassium and sodium changes alter the gradient differently.