WGU D440
HESI Nutrition
Objective Assessment
(3 Full Exams Set)
Actual Questions with Verified Answers
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➢250 OA Exam Questions w/ Answers
➢ (Victoria + Kareem + Stephanie Study Guides)
➢ Expert Rationales included.
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Table of Contents
D440 (OA) Set 1 ................................................................. 2
D440 (OA) Set 2 ............................................................... 34
D440 (OA) Set 3 ............................................................... 82
D440 (Victoria + Kareem + Stephanie Study Guides) ....... 121
D440 (OA) Set 1
Case Study: Postoperative Dietary Management
A nurse is providing discharge instructions to a client who underwent a laparoscopic
cholecystectomy earlier in the week. The client asks for specific guidance on dietary
modifications to prevent complications during recovery.
Question 1. Which dietary instruction should the nurse include in the discharge
teaching plan?
A. Maintain a low-fat diet for 6 weeks to reduce bile demand
B. Follow a high-protein, high-calorie diet to promote incision healing
C. Begin a clear liquid diet for the first 2 weeks post-discharge
D. Avoid all dairy products permanently to prevent gallstone recurrence
Correct Answer: A
Rationale:
After laparoscopic cholecystectomy, the liver continues to produce bile but no longer
stores it in a concentrated form. A low-fat diet for approximately 4–6 weeks reduces the
demand for bile and minimizes gastrointestinal distress, bloating, and diarrhea. Option B
is incorrect because while protein is important, high-fat content would strain the
digestive system. Option C is unnecessary beyond the immediate postoperative period.
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Option D is incorrect because dairy avoidance is not required unless the client has
concurrent lactose intolerance.
Question 2. A client hospitalized with partial-thickness and full-thickness burns to
both legs is prescribed a high-calorie, high-protein diet. Which breakfast
selection should the nurse encourage the client to consume?
A. Oatmeal with sliced banana and herbal tea
B. Scrambled eggs, sausage, and orange juice
C. Whole wheat toast with jelly and black coffee
D. Fresh fruit salad with low-fat yogurt
Correct Answer: B
Rationale:
Burn injuries create a hypermetabolic state with significant protein and calorie losses
through wound exudate. Scrambled eggs and sausage provide high biological value
protein and calories necessary for wound healing and tissue regeneration. Orange juice
offers vitamin C for collagen synthesis. Option A lacks adequate protein. Option C is
insufficient in protein and calories. Option D is too low in protein and energy density for
burn recovery needs.
Question 3. A nurse instructs a client with type 2 diabetes mellitus to avoid
refined sugars and simple carbohydrates. Which food selection indicates the
client understands the dietary teaching?
A. White rice with stir-fried vegetables
B. Avocado slices with lemon juice
C. Baked potato with sour cream
D. Pretzels with hummus
Correct Answer: B
Rationale:
Avocado is rich in monounsaturated fats and fiber with minimal carbohydrate impact,
making it ideal for glycemic control. White rice (A), baked potatoes (C), and pretzels (D)
are high in carbohydrates that rapidly convert to glucose, potentially causing
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D440 (OA) Set 2
Case Study: Adolescent with Type 1 Diabetes
An adolescent male, approximately 14 years old, became unresponsive at soccer
practice. Coaches called an ambulance. The client has type 1 diabetes. Friends said he
was complaining of not feeling well earlier that day. He didn't seem to eat much at lunch
but had cheese and nuts before practice. The client is known to self-administer insulin.
There is no history of smoking or alcohol.
Vital Signs & Assessment:
• Height: 65 inches (165 cm)
• Weight: 110 lbs (50 kg)
• BMI: 18.3 kg/m²
• Temperature: 37°C (98.6°F)
• Blood Pressure: 130/83 mmHg
• Pulse: 97 bpm
• O₂ Saturation: 98%
• Respirations: 18/min
• Blood Glucose: 50 mg/dL (2.8 mmol/L)
1. The nurse recognizes that this client's blood glucose level indicates which
condition?
A. Hyperglycemia
B. Hypoglycemia
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C. Normal glucose tolerance
D. Diabetic ketoacidosis
Correct Answer: B
Rationale:
A blood glucose level below 70 mg/dL is indicative of hypoglycemia. The client
consumed noncarbohydrate foods (cheese and nuts) before practice, which would not
support normal blood glucose during physical activity. The elevated blood pressure
(130/83 mmHg) is a compensatory response to low blood glucose, not hypotension.
There is no evidence of hyperglycemia or diabetic ketoacidosis in this scenario.
2. Which intervention is the priority for the nurse to implement for this client?
A. Administer insulin subcutaneously
B. Provide 15 grams of simple carbohydrates
C. Give 30 grams of fruit juice immediately
D. Monitor electrolytes and fluid balance
Correct Answer: B
Rationale:
During hypoglycemic episodes, 15 grams of simple carbohydrates should be consumed,
such as sugar, honey, fruit juice, or glucose tablets. Wheat bread is not a simple
carbohydrate, and although it contains carbohydrates, the body responds best to simple
sugars. Administering insulin would further lower blood glucose and is contraindicated.
While 30 grams of fruit juice is a simple carbohydrate, it is too much to administer at one
time and may result in rebound hyperglycemia. Monitoring electrolytes and fluids is
important but secondary to blood glucose regulation, which is the first priority.
3. Which statement by the nurse is most appropriate regarding ongoing care for
this client?
A. "It is important to monitor your insulin dosage after you regain consciousness."
B. "You should avoid fluids until your blood glucose stabilizes."
C. "We need to monitor your vitals and blood glucose to ensure you maintain
consciousness."
D. "Your blood pressure indicates you are experiencing hypotension."
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D440 (OA) Set 3
1. A nurse is conducting a nutritional assessment for a healthy 35-year-old client.
Which guideline should the nurse use as the preferred reference for evaluating
whether the client’s diet meets optimal nutrient intake standards?
A. Recommended Dietary Allowances (RDA) alone
B. Dietary Reference Intakes (DRIs)
C. MyPlate daily checklist
D. Estimated Average Requirements (EAR)
Correct Answer: B
Rationale:
The Dietary Reference Intakes (DRIs) are the comprehensive set of reference values
used for assessing and planning diets in healthy people. They include the RDA, EAR,
Adequate Intake (AI), and Tolerable Upper Intake Level (UL), providing a complete
framework for evaluating nutrient adequacy and preventing both deficiency and excess.
While MyPlate offers practical food guidance, the DRIs are the scientific standard for
nutrient evaluation.
2. A community health nurse is developing a nutrition education program for
adults over 50. At what age do the Dietary Reference Intakes indicate that nutrient
requirements begin to change for this population?
A. 40 years old
B. 50 years old
C. 60 years old
D. 65 years old
Correct Answer: B
Rationale:
The DRIs specify that nutrient requirements change at 50 years of age for adults. This
milestone triggers adjustments in recommendations for several nutrients, including
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vitamin B12 absorption considerations and altered energy needs due to metabolic shifts
and decreased physical activity commonly seen in this age group.
3. A nursing student asks the clinical instructor for the correct term describing
the discipline that applies nutrition science to promote health and treat disease.
Which term should the instructor provide?
A. Nutrition science
B. Dietetics
C. Nutritional epidemiology
D. Food chemistry
Correct Answer: B
Rationale:
Dietetics is the professional discipline that applies the principles of nutrition science to
promote human health, prevent disease, and manage medical conditions through
therapeutic diets. Registered Dietitian Nutritionists (RDNs) practice dietetics in clinical,
community, and foodservice settings.
4. An older adult client asks the nurse which nutrient becomes especially
important to include in her menu plan as she ages. Which recommendation is
most appropriate?
A. Foods fortified with vitamin D
B. Foods fortified with vitamin B12
C. Foods high in iron
D. Foods high in folic acid
Correct Answer: B
Rationale:
As adults age, particularly after 50 years, the ability to absorb naturally occurring vitamin
B12 from food declines due to reduced gastric acid production. The DRI therefore
recommends that older adults obtain vitamin B12 from fortified foods or supplements to
ensure adequate intake and prevent deficiency-related neurological and hematological
complications.
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D440 (Victoria + Kareem + Stephanie Study Guides)
Know blood tests test nutritional status: ...
BMI and albumin
PT who has issues swallowing (dysphagia) will always be the most at risk for ...
nutrition deficiency.
Which patient would need more water?
(A. Breastfeeding)
know what diet for a pt who lost their dentures would be on
mechanical soft
Athletic patient complains with leg cramps due to low calcium, offer...
broccoli, cheese.
Know nutrient dense foods.
???
Folic acid Is found in ....
yogurt.
1 oz = ? mL
30 ml
1 cup = ? oz
8 oz
BMI Ranges:
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18.5-24.9 = normal
25-29.9 = overweight
30 and over = obese
(these values were on test)
Fat = ? per gram
Carbs = ? per gram
Protein = ? per gram
9
4
4
Glomerulonephritis diet: caused by untreated strep (a kidney disease)
Fluid restriction
Sodium restriction (salty meats & processed foods)
Decrease Protein
Increase carbs (Carbs provide energy and stop the breakdown of proteins)
Renal Disease diet
fluid restriction, Low sodium, Low protein, low potassium, high calcium
Urinary Tract infections (UTI) diet:
Cranberries, blueberries, raspberries, and other berries, probiotics (yogurt)
Avoid foods and drinks that cause bladder irritation, such as coffee, tea, soft
drinks, and chocolate, avoid smoking.
Diabetic needs to drink sugar-free cranberry juices
Heart Failure diet
Fluid restriction (spread out fluids during the day & suck on hard candy to
decrease thirst)
Decrease sodium, fat, & cholesterol