NR228/NR 228 Exam 4 V2 | Nutrition, Health &
Wellness Q&A with Rationale | Chamberlain
University
1. A nurse is providing education to a pregnant client with a pre-pregnancy BMI of 22. Which
of the following recommendations for total weight gain is appropriate?
A. 11 to 20 pounds
B. 15 to 25 pounds
C. 28 to 40 pounds
D. 25 to 35 pounds
Correct Answer: D
Explanation: A client with a normal pre-pregnancy BMI (18.5–24.9) is advised to gain
between 25 and 35 pounds during gestation. This weight gain supports fetal development,
placenta growth, and maternal tissue changes. Insufficient weight gain can increase the risk
of a low-birth-weight infant and other developmental complications.
2. Which nutrient is essential to supplement in the diet of a 4-month-old infant who is
exclusively breastfed?
A. Sodium
B. Vitamin C
C. Calcium
,D. Vitamin D
Correct Answer: D
Explanation: Breast milk is naturally low in Vitamin D, which is necessary for calcium
absorption and bone health. The American Academy of Pediatrics recommends a daily
supplement of 400 IU starting shortly after birth for exclusively breastfed infants. Failure to
provide adequate Vitamin D can lead to the development of rickets in growing children.
3. A patient with Type 2 Diabetes is learning about carbohydrate counting. Which of the
following equals one carbohydrate serving?
A. 1 slice of bread
B. 1 cup of cooked pasta
C. 2 cups of milk
D. 1 medium apple
Correct Answer: A
Explanation: One carbohydrate serving is defined as approximately 15 grams of
carbohydrates, which is found in one slice of bread. While an apple contains carbs, a
‘medium’ one might exceed 15g depending on size, whereas a slice of bread is a
standardized unit. Mastering carbohydrate counting allows patients to maintain tighter
glycemic control and manage insulin dosages effectively.
, 4. When initiating enteral nutrition via a nasogastric tube, what is the gold standard for
confirming correct tube placement?
A. Auscultation of an air bolus
B. Testing the pH of gastric aspirate
C. Observing for respiratory distress
D. Radiographic visualization (X-ray)
Correct Answer: D
Explanation: Radiographic visualization is the only definitive method to ensure that a
feeding tube is located in the stomach rather than the lungs. Auscultation is no longer
considered a reliable method due to the potential for misleading sounds. Nurses must
confirm placement before every feeding or medication administration to prevent
aspiration pneumonia.
5. A nurse is caring for a client with chronic kidney disease (CKD) who is not on dialysis. Which
dietary restriction is most critical for this patient?
A. High carbohydrate intake
B. Limited protein intake
C. Increased fluid intake
D. Excessive Vitamin C
Correct Answer: B
Wellness Q&A with Rationale | Chamberlain
University
1. A nurse is providing education to a pregnant client with a pre-pregnancy BMI of 22. Which
of the following recommendations for total weight gain is appropriate?
A. 11 to 20 pounds
B. 15 to 25 pounds
C. 28 to 40 pounds
D. 25 to 35 pounds
Correct Answer: D
Explanation: A client with a normal pre-pregnancy BMI (18.5–24.9) is advised to gain
between 25 and 35 pounds during gestation. This weight gain supports fetal development,
placenta growth, and maternal tissue changes. Insufficient weight gain can increase the risk
of a low-birth-weight infant and other developmental complications.
2. Which nutrient is essential to supplement in the diet of a 4-month-old infant who is
exclusively breastfed?
A. Sodium
B. Vitamin C
C. Calcium
,D. Vitamin D
Correct Answer: D
Explanation: Breast milk is naturally low in Vitamin D, which is necessary for calcium
absorption and bone health. The American Academy of Pediatrics recommends a daily
supplement of 400 IU starting shortly after birth for exclusively breastfed infants. Failure to
provide adequate Vitamin D can lead to the development of rickets in growing children.
3. A patient with Type 2 Diabetes is learning about carbohydrate counting. Which of the
following equals one carbohydrate serving?
A. 1 slice of bread
B. 1 cup of cooked pasta
C. 2 cups of milk
D. 1 medium apple
Correct Answer: A
Explanation: One carbohydrate serving is defined as approximately 15 grams of
carbohydrates, which is found in one slice of bread. While an apple contains carbs, a
‘medium’ one might exceed 15g depending on size, whereas a slice of bread is a
standardized unit. Mastering carbohydrate counting allows patients to maintain tighter
glycemic control and manage insulin dosages effectively.
, 4. When initiating enteral nutrition via a nasogastric tube, what is the gold standard for
confirming correct tube placement?
A. Auscultation of an air bolus
B. Testing the pH of gastric aspirate
C. Observing for respiratory distress
D. Radiographic visualization (X-ray)
Correct Answer: D
Explanation: Radiographic visualization is the only definitive method to ensure that a
feeding tube is located in the stomach rather than the lungs. Auscultation is no longer
considered a reliable method due to the potential for misleading sounds. Nurses must
confirm placement before every feeding or medication administration to prevent
aspiration pneumonia.
5. A nurse is caring for a client with chronic kidney disease (CKD) who is not on dialysis. Which
dietary restriction is most critical for this patient?
A. High carbohydrate intake
B. Limited protein intake
C. Increased fluid intake
D. Excessive Vitamin C
Correct Answer: B
