NUTRITION NBNSC-CNSC日本語、NBNSC-CNSC受験練習参考書
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NUTRITION NBNSC Certified Nutrition Support Clinician (CCN) 認定 NBNSC-CNSC 試験問題 (Q61-Q66):
質問 # 61
The guideline for fat intake for 2-3 year olds is:
- A. 20-25%
- B. 30-35%
- C. 35-40%
- D. 50%
正解:B
解説:
The correct guideline for fat intake for children aged 2-3 years old is 30-35% of their total daily caloric intake. This recommendation is part of a dietary approach that supports the developmental needs of toddlers, who require a certain amount of fat for healthy growth, brain development, and overall well-being.
Up until the age of 2, whole milk is recommended because it provides the essential fats necessary for rapid brain development that occurs during this stage of life. However, once children reach the age of 2, the dietary focus shifts slightly. At this point, it is advised to switch from whole milk to low-fat or fat-free milk. This change helps to moderate fat intake, ensuring it does not exceed the necessary amount which could otherwise lead to health issues such as obesity.
The 30-35% fat intake guideline for 2-3 year olds is set to provide a balanced amount of fats that are crucial for their continued development. This range is carefully calculated to supply adequate energy and essential fatty acids, which are vital for cognitive development and the absorption of fat-soluble vitamins (A, D, E, and K).
As children grow older, from the age of 4 to 18, the recommended fat intake slightly adjusts to 25-35% of total calories. This adjustment reflects the changing nutritional needs as children grow and become more active, requiring different caloric distributions for optimal health. Additionally, it is recommended that no more than 7% of their daily caloric intake should come from saturated fats. This helps in preventing the development of cardiovascular diseases and maintaining healthy cholesterol levels.
It is important for caregivers and parents to monitor and adjust the diet according to these guidelines to promote healthy eating habits from a young age. Such practices help in setting a foundation for a healthy lifestyle as the child grows into adulthood.
質問 # 62
Cascara sagrada is:
- A. root
- B. none of the above
- C. berry
- D. bark
正解:D
解説:
**Cascara sagrada** is a medicinal bark derived from the Rhamnus purshiana tree, which is native to the western part of North America, from southern Alaska to central California. It is most commonly recognized and used for its natural laxative effects.
The primary active compounds in cascara sagrada are anthraquinones, which are potent stimulant laxatives. These compounds work by promoting contractions in the colon, which helps to move stool through the bowels. This action makes it effective in treating constipation and maintaining regular bowel movements. Additionally, it increases the secretion of water and electrolytes in the intestines, further easing the passage of stool.
Cascara sagrada is not only used for constipation but also for other digestive disorders. It can be helpful in cases of colon cleansing before diagnostic procedures like colonoscopy. Despite its effectiveness, cascara sagrada should be used cautiously as overuse can lead to complications such as electrolyte imbalance, dehydration, and dependency, where the bowels become reliant on the laxative to function.
The use of cascara sagrada in tea form is quite common, though it is noted for its very bitter taste which can be off-putting for many. This bitterness is primarily due to the anthraquinones. To make it more palatable, it is often mixed with other herbs or flavorings to mask the bitterness.
While cascara sagrada offers several benefits for digestive health, it should be used under the guidance of a healthcare provider to avoid potential side effects and interactions with other medications. It is usually recommended for short-term use only, as long-term use can lead to several health issues, including a dependency on laxatives for bowel movements.
In summary, cascara sagrada is valued primarily for its effectiveness as a laxative and a colon cleanser. It is derived from the bark of the Rhamnus purshiana tree and has been used both traditionally and in modern medicine to treat constipation and prepare for colon examinations. However, due to its strong laxative properties and bitter taste, its use must be managed carefully.
質問 # 63
In TCM, diabetes is typically considered to be caused by all of the following except:
- A. appropriate diet
- B. insufficient rest
- C. congenital deficiency
- D. inappropriate diet
正解:A
解説:
In Traditional Chinese Medicine (TCM), the understanding and treatment of diabetes are quite different from Western medicine. TCM views the body as a network of energy systems that must remain in balance to maintain health. Diabetes, referred to as "Xiao Ke" disease in TCM, is often associated with symptoms like excessive thirst, hunger, and urination. According to TCM theory, the roots of diabetes can be traced back to factors such as congenital deficiency, inappropriate diet, overwork, and insufficient rest.
Congenital deficiency in TCM refers to inherent weaknesses in the body's constitution. This might be due to hereditary factors or issues that occurred during the prenatal period that affect the Qi (vital energy) and the functioning of organs like the spleen, kidney, and pancreas, which are considered crucial in the metabolism of fluids and nutrients in the body.
An inappropriate diet is another major factor believed to cause diabetes in TCM. Consuming foods that are too sweet, rich, or greasy can create an imbalance by generating excessive heat and dampness in the body. This imbalance can lead to the accumulation of phlegm and stasis, which disrupts the normal functioning of the spleen and pancreas, eventually leading to symptoms associated with diabetes.
Overwork and insufficient rest both contribute to the depletion of the body's vital substances, including Qi and Yin. This depletion can lead to a state where the body lacks the necessary energy to perform its metabolic functions effectively. In TCM, the kidney is believed to be particularly affected by overwork and insufficient rest, and kidney health is crucial in the regulation of the body's fluids and overall energy balance.
Contrary to these factors, an appropriate diet is actually recommended in TCM to prevent or manage diabetes. A balanced diet that includes all five tastes - sweet, sour, bitter, pungent, and salty - but emphasizes more bitter and sour foods, can help in maintaining proper glucose levels and overall body balance. Foods that are particularly beneficial are those that promote Yin and Qi, such as barley, yams, mushrooms, and blueberries.
Therefore, when considering the factors listed in the question congenital deficiency , inappropriate diet, overwork, insufficient rest, and appropriate diet, it is clear that "appropriate diet" is not considered a cause of diabetes in TCM but rather part of its management and prevention. Hence, it is the correct answer to the question of what is typically not considered a cause of diabetes in Traditional Chinese Medicine.
質問 # 64
Serum is:
- A. the fluid from blood after blood cells and clots are removed
- B. the result of random samples or timed collections of feces
- C. scrapings and biopsy samples
- D. the fluid from blood centrifuged with anticoagulants
正解:A
解説:
Serum is a component of blood that is obtained after the removal of blood cells and the clotting factors. To understand what serum is, it's crucial to know how it is derived from blood. Blood consists of several components including red blood cells, white blood cells, platelets, and plasma. When blood is drawn and allowed to clot, the solid components (blood cells and clotting factors) form a clot, and the remaining liquid is what is known as serum.
This process can be facilitated by centrifugation, where the blood is spun at high speeds, causing the heavier components like blood cells and clotting factors to separate and settle at the bottom, leaving the serum as the supernatant fluid. It is essential that anticoagulants are not used in this process because their presence prevents clotting, leading instead to the creation of plasma, not serum.
Serum plays a significant role in medical diagnostics. It is commonly used in laboratory assessments as it serves as a rich source of biomarkers-substances that can be measured to assess the health of an individual. For instance, serum levels of glucose, cholesterol, proteins, and hormones can provide valuable insights into a person's metabolic processes and whether they are within normal ranges or indicative of a disease.
Furthermore, serum is used in the detection of antibodies indicating infections, autoimmune disorders, and exposure to certain pathogens. Therefore, it is a crucial tool in both clinical diagnosis and management of various medical conditions. It helps in the evaluation, diagnosis, and monitoring of patients in a broad spectrum of healthcare settings.
質問 # 65
Which of the statements is Not true?
- A. Eating disorders are associated with shame.
- B. Eating disorders do not overlap.
- C. Eating disorders are easier to control if diagnosed early.
- D. Women are more likely to develop eating disorders.
正解:B
解説:
The statement "Eating disorders do not overlap" is not true. Eating disorders can indeed overlap, meaning a person can exhibit symptoms of more than one type of eating disorder at the same time. For instance, an individual diagnosed with anorexia nervosa, a disorder characterized by an intense fear of gaining weight and a distorted body image, may also engage in behaviors typical of bulimia nervosa, such as purging (self-induced vomiting) after eating. This overlapping of disorders complicates diagnosis and treatment, highlighting the complexity of eating disorders and the need for a comprehensive assessment by healthcare professionals.
Furthermore, the interplay between different eating disorders can manifest in various forms. A person might primarily suffer from binge eating disorder, characterized by frequent episodes of eating large quantities of food (often quickly and to the point of discomfort), and might also exhibit periods of restrictive eating akin to those seen in anorexia. The combination of symptoms from different eating disorders can lead to a diagnosis of an "unspecified feeding or eating disorder" (UFED), according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), if the symptoms cause significant distress or impairment but do not meet the full criteria for any one disorder.
Contrary to the erroneous statement, the reality of overlapping symptoms in eating disorders underscores the importance of a nuanced approach to treatment that addresses the full spectrum of behaviors and psychological components presented by an individual. Treatment plans often need to be highly personalized and may involve a combination of psychological therapy, nutritional counseling, and medical support. This comprehensive approach helps tackle the multifaceted nature of eating disorders, which may overlap not only with each other but also with other psychological issues such as anxiety, depression, and obsessive-compulsive disorder.
In summary, the claim that "Eating disorders do not overlap" is a misconception. Understanding the potential for overlap is crucial for effective diagnosis and treatment. Recognizing the complexity and individual variations in eating disorders can lead to better, more effective treatment outcomes for those affected.
質問 # 66
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