Correct Answer: A

Rationale: Patients with periodontal disease may require increased protein intake due to the physiological response to inflammation and infection, which can negatively impact protein synthesis. Protein is essential for wound healing and tissue repair, and an infection can increase the body's protein requirements. Therefore, ensuring an adequate protein intake is particularly important for these patients. Choice A is correct because the statement and reason are both accurate and directly related to each other, supporting the increased protein needs in patients with periodontal disease. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

Correct Answer: D

Rationale: A diet manual typically contains guidance on specific food preparation methods to ensure proper nutrition and health for individuals following the diet. Therefore, choice D is correct. Choices A and B refer to sanitation procedures and staff hygiene issues, which are important but not typically the focus of a diet manual. Choice C, regarding specific patients' resting metabolic rates, is too individualized and detailed for a general diet manual, as it would be part of a personalized dietary plan developed with a healthcare professional.

Correct Answer: D

Rationale: In a patient with liver cirrhosis, weight gain due to fluid retention can mask Protein-Energy Malnutrition (PEM) symptoms. This can lead to an increase in weight, making it challenging to identify weight loss or muscle wasting associated with PEM. Therefore, option D is correct. Options A, B, and C are incorrect because fluid retention and weight gain related to liver cirrhosis do not necessarily hide the symptoms of liver failure, gallbladder disease, or heart failure.

Correct Answer: C

Rationale: Fat provides 9 kcal per gram, so 35 grams of fat provides 315 kcal. Therefore, the correct answer is C. Choice A (140) is incorrect because it doesn't consider the energy content of fat. Choice B (245) is incorrect as it miscalculates the kilocalories provided by 35g of fat. Choice D (360) is incorrect because it overestimates the kilocalories provided by 35g of fat.

Correct Answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.