ATI NUTRITION
Exam Review for Nursing Students
COMPREHENSIVE PRACTICE QUESTION BANK
120 Original Multiple-Choice Items with Rationales & Distractor Analysis
Seventeen Content Domains
1. Nutrition Across the Lifespan · 9 items
2. Clinical Nutrition & Therapeutic Diets · 7 items
3. Enteral & Parenteral Nutrition · 8 items
4. Laboratory Values & Nutritional Assessment · 7 items
5. Macronutrients: Carbohydrate, Protein & Fat Metabolism · 8 items
6. Vitamins & Minerals · 9 items
7. Fluid, Electrolyte Balance & Refeeding Syndrome · 7 items
8. Diabetes & Metabolic Syndrome · 7 items
9. Gastrointestinal Disorders & Malnutrition · 8 items
10. Renal & Immune Nutrition · 5 items
11. Cardiovascular Nutrition · 5 items
12. Eating Disorders, Obesity & Weight Management · 6 items
13. Nutrition & Medications · 5 items
14. Food Safety & Foodborne Illness · 6 items
15. Digestion, Absorption & Energy Balance · 8 items
16. Cultural, Psychosocial & Community Nutrition · 7 items
17. Integrated Clinical Review · 8 items
,How to Use This Question Bank
Structure of each item
▸ Stem — A clinical vignette or concept prompt written at the graduate-nursing level.
▸ Options — Four choices in randomized order. Correct answers are not positionally patterned.
▸ Correct answer — Marked in bold green so you can scan quickly during review.
▸ Rationale — Why the correct answer is correct, grounded in mechanism rather than memorization.
▸ Distractor analysis — Why each incorrect option is wrong — often the most valuable part, because
exam errors usually come from a plausible-but-wrong mental model.
▸ Clinical pearl — A high-yield extension: mnemonics, lab values, contrasts, and the trap the item is
built on.
A suggested study method
1. Cover the answer block with a sheet of paper and commit to one option before reading further. Passive
recognition feels like learning but does not survive exam conditions.
2. Before checking, write one sentence explaining why you rejected each other option. If you cannot, you
guessed — flag the item.
3. Read the distractor analysis even when you answered correctly. Roughly half the value of a question
bank lives in the three options you did not pick.
4. Return to flagged items after 48 hours. Spaced retrieval outperforms rereading by a wide margin.
5. Use the answer key on the final page for rapid re-testing once you have worked through a section.
,Section 1 — Nutrition Across the Lifespan
Pregnancy and lactation, infant and pediatric feeding, adolescent needs, and older adult nutrition.
Question 1. A nurse is counseling a woman who is planning pregnancy. Which supplement
recommendation is the priority for preventing neural tube defects?
A. 27 mg of elemental iron daily beginning after the first missed period
B. 10,000 IU of vitamin A daily throughout pregnancy
C. 400 mcg of folic acid daily, beginning at least one month before conception and
continuing through the first trimester
D. 1,000 mg of calcium daily beginning in the second trimester
✓ Correct answer: C
Rationale. The neural tube closes by day 26-28 of gestation — often before a woman knows she is
pregnant. This is why folic acid must be started PRECONCEPTION. All people capable of pregnancy
are advised to consume 400 mcg daily; the recommendation rises to 600 mcg during pregnancy, and to
4 mg daily for those with a prior NTD-affected pregnancy.
Distractor analysis.
A — Iron prevents maternal anemia and supports expanded blood volume, but does not prevent NTDs;
starting after a missed period is also too late for neural tube closure.
B — High-dose preformed vitamin A (retinol) is TERATOGENIC in pregnancy and is specifically avoided
— this is a dangerous distractor.
D — Calcium supports fetal skeletal mineralization but has no role in neural tube closure, and needs are
usually met by diet.
Clinical pearl. Food sources of folate: leafy greens, legumes, citrus, fortified cereals and grains. Folate
deficiency causes megaloblastic anemia identical in appearance to B12 deficiency — but folate does NOT
correct the neurologic damage of B12 deficiency, which is why B12 must be ruled out before high-dose
folate.
Question 2. A pregnant client at 10 weeks gestation reports persistent nausea. Which teaching is
most appropriate?
A. Skip breakfast entirely and eat one large meal in the evening
B. Increase intake of high-fat fried foods to coat the stomach lining
C. Eat small, frequent, dry carbohydrate snacks such as crackers before rising, and
separate fluids from solid meals
D. Drink large volumes of fluid with each meal to dilute stomach acid
✓ Correct answer: C
Rationale. Morning sickness is best managed by avoiding an empty stomach and reducing gastric
distention. Dry carbohydrates before getting out of bed, small frequent meals, and drinking fluids
between rather than with meals all reduce nausea. Cold foods and avoiding strong odors also help.
Distractor analysis.
A — Prolonged fasting worsens nausea and promotes ketosis, which is undesirable in pregnancy.
B — High-fat and fried foods delay gastric emptying and typically aggravate nausea.
D — Large fluid volumes with meals increase gastric distention and worsen nausea.
Clinical pearl. Escalate concern to hyperemesis gravidarum when there is weight loss over 5% of
prepregnancy weight, ketonuria, dehydration, and electrolyte disturbance — that requires IV fluids,
thiamine, and antiemetics, not diet teaching alone.
, Question 3. A client who is breastfeeding asks about her nutritional needs. Which response is
accurate?
A. An additional 330-400 kcal per day and roughly 3.0 liters of total daily fluid are
recommended during lactation
B. Alcohol is safe in any amount because it does not enter breast milk
C. Caloric needs return to prepregnancy levels immediately after delivery
D. Fluid intake should be restricted to prevent breast engorgement
✓ Correct answer: A
Rationale. Milk production is energy- and fluid-intensive. Lactating individuals need roughly 330
kcal/day extra in the first 6 months and about 400 kcal/day in the second 6 months, above
prepregnancy requirements. Total fluid needs rise to approximately 3.0 L/day, and thirst is a
reasonable guide.
Distractor analysis.
B — Alcohol readily passes into breast milk in concentrations paralleling maternal blood levels; clients
should wait about 2 hours per standard drink before nursing.
C — Caloric needs are HIGHER during lactation than during pregnancy for many clients — they do not
return to baseline immediately.
D — Fluid restriction reduces milk supply; engorgement is managed by frequent effective emptying of the
breast, not dehydration.
Clinical pearl. Lactation also increases needs for protein, vitamin A, vitamin C, and iodine. Note the
exception: IRON needs actually DROP during lactation (often below prepregnancy levels) because
menstruation is typically suppressed.
Question 4. Parents ask when to introduce solid foods to their healthy full-term infant. Which
response reflects current recommendations?
A. At 3 months, beginning with honey-sweetened cereal to encourage acceptance
B. At 2 months, starting with diluted cow's milk in a bottle
C. At 6 months, when the infant can sit with support, has good head control, and
shows loss of the extrusion reflex
D. At 12 months, since breast milk or formula alone is adequate for the entire first year
✓ Correct answer: C
Rationale. Complementary foods are introduced around 6 months, guided by developmental
readiness rather than the calendar alone: sitting with support, steady head and neck control,
disappearance of the tongue-thrust (extrusion) reflex, and interest in food. By 6 months, infant iron
stores from birth are depleted, making iron-rich complementary foods important.
Distractor analysis.
A — Honey is CONTRAINDICATED before 12 months due to the risk of infant botulism from Clostridium
botulinum spores; 3 months is also too early developmentally.
B — Cow's milk is not appropriate before 12 months — it causes GI blood loss, is low in iron, and imposes
a high renal solute load.
D — Waiting until 12 months risks iron deficiency and may impair acceptance of textures and self-feeding
skills.
Clinical pearl. Introduce one new single-ingredient food at a time and wait 3-5 days before the next, to
identify allergic reactions. Current guidance actually favors EARLY introduction of allergens such as
peanut (around 4-6 months in high-risk infants) to reduce allergy development — a reversal of older
advice.
Question 5. A nurse assesses a 16-month-old whose parents report he drinks 40 ounces of whole
milk daily and eats very little solid food. Which deficiency is most likely?
Exam Review for Nursing Students
COMPREHENSIVE PRACTICE QUESTION BANK
120 Original Multiple-Choice Items with Rationales & Distractor Analysis
Seventeen Content Domains
1. Nutrition Across the Lifespan · 9 items
2. Clinical Nutrition & Therapeutic Diets · 7 items
3. Enteral & Parenteral Nutrition · 8 items
4. Laboratory Values & Nutritional Assessment · 7 items
5. Macronutrients: Carbohydrate, Protein & Fat Metabolism · 8 items
6. Vitamins & Minerals · 9 items
7. Fluid, Electrolyte Balance & Refeeding Syndrome · 7 items
8. Diabetes & Metabolic Syndrome · 7 items
9. Gastrointestinal Disorders & Malnutrition · 8 items
10. Renal & Immune Nutrition · 5 items
11. Cardiovascular Nutrition · 5 items
12. Eating Disorders, Obesity & Weight Management · 6 items
13. Nutrition & Medications · 5 items
14. Food Safety & Foodborne Illness · 6 items
15. Digestion, Absorption & Energy Balance · 8 items
16. Cultural, Psychosocial & Community Nutrition · 7 items
17. Integrated Clinical Review · 8 items
,How to Use This Question Bank
Structure of each item
▸ Stem — A clinical vignette or concept prompt written at the graduate-nursing level.
▸ Options — Four choices in randomized order. Correct answers are not positionally patterned.
▸ Correct answer — Marked in bold green so you can scan quickly during review.
▸ Rationale — Why the correct answer is correct, grounded in mechanism rather than memorization.
▸ Distractor analysis — Why each incorrect option is wrong — often the most valuable part, because
exam errors usually come from a plausible-but-wrong mental model.
▸ Clinical pearl — A high-yield extension: mnemonics, lab values, contrasts, and the trap the item is
built on.
A suggested study method
1. Cover the answer block with a sheet of paper and commit to one option before reading further. Passive
recognition feels like learning but does not survive exam conditions.
2. Before checking, write one sentence explaining why you rejected each other option. If you cannot, you
guessed — flag the item.
3. Read the distractor analysis even when you answered correctly. Roughly half the value of a question
bank lives in the three options you did not pick.
4. Return to flagged items after 48 hours. Spaced retrieval outperforms rereading by a wide margin.
5. Use the answer key on the final page for rapid re-testing once you have worked through a section.
,Section 1 — Nutrition Across the Lifespan
Pregnancy and lactation, infant and pediatric feeding, adolescent needs, and older adult nutrition.
Question 1. A nurse is counseling a woman who is planning pregnancy. Which supplement
recommendation is the priority for preventing neural tube defects?
A. 27 mg of elemental iron daily beginning after the first missed period
B. 10,000 IU of vitamin A daily throughout pregnancy
C. 400 mcg of folic acid daily, beginning at least one month before conception and
continuing through the first trimester
D. 1,000 mg of calcium daily beginning in the second trimester
✓ Correct answer: C
Rationale. The neural tube closes by day 26-28 of gestation — often before a woman knows she is
pregnant. This is why folic acid must be started PRECONCEPTION. All people capable of pregnancy
are advised to consume 400 mcg daily; the recommendation rises to 600 mcg during pregnancy, and to
4 mg daily for those with a prior NTD-affected pregnancy.
Distractor analysis.
A — Iron prevents maternal anemia and supports expanded blood volume, but does not prevent NTDs;
starting after a missed period is also too late for neural tube closure.
B — High-dose preformed vitamin A (retinol) is TERATOGENIC in pregnancy and is specifically avoided
— this is a dangerous distractor.
D — Calcium supports fetal skeletal mineralization but has no role in neural tube closure, and needs are
usually met by diet.
Clinical pearl. Food sources of folate: leafy greens, legumes, citrus, fortified cereals and grains. Folate
deficiency causes megaloblastic anemia identical in appearance to B12 deficiency — but folate does NOT
correct the neurologic damage of B12 deficiency, which is why B12 must be ruled out before high-dose
folate.
Question 2. A pregnant client at 10 weeks gestation reports persistent nausea. Which teaching is
most appropriate?
A. Skip breakfast entirely and eat one large meal in the evening
B. Increase intake of high-fat fried foods to coat the stomach lining
C. Eat small, frequent, dry carbohydrate snacks such as crackers before rising, and
separate fluids from solid meals
D. Drink large volumes of fluid with each meal to dilute stomach acid
✓ Correct answer: C
Rationale. Morning sickness is best managed by avoiding an empty stomach and reducing gastric
distention. Dry carbohydrates before getting out of bed, small frequent meals, and drinking fluids
between rather than with meals all reduce nausea. Cold foods and avoiding strong odors also help.
Distractor analysis.
A — Prolonged fasting worsens nausea and promotes ketosis, which is undesirable in pregnancy.
B — High-fat and fried foods delay gastric emptying and typically aggravate nausea.
D — Large fluid volumes with meals increase gastric distention and worsen nausea.
Clinical pearl. Escalate concern to hyperemesis gravidarum when there is weight loss over 5% of
prepregnancy weight, ketonuria, dehydration, and electrolyte disturbance — that requires IV fluids,
thiamine, and antiemetics, not diet teaching alone.
, Question 3. A client who is breastfeeding asks about her nutritional needs. Which response is
accurate?
A. An additional 330-400 kcal per day and roughly 3.0 liters of total daily fluid are
recommended during lactation
B. Alcohol is safe in any amount because it does not enter breast milk
C. Caloric needs return to prepregnancy levels immediately after delivery
D. Fluid intake should be restricted to prevent breast engorgement
✓ Correct answer: A
Rationale. Milk production is energy- and fluid-intensive. Lactating individuals need roughly 330
kcal/day extra in the first 6 months and about 400 kcal/day in the second 6 months, above
prepregnancy requirements. Total fluid needs rise to approximately 3.0 L/day, and thirst is a
reasonable guide.
Distractor analysis.
B — Alcohol readily passes into breast milk in concentrations paralleling maternal blood levels; clients
should wait about 2 hours per standard drink before nursing.
C — Caloric needs are HIGHER during lactation than during pregnancy for many clients — they do not
return to baseline immediately.
D — Fluid restriction reduces milk supply; engorgement is managed by frequent effective emptying of the
breast, not dehydration.
Clinical pearl. Lactation also increases needs for protein, vitamin A, vitamin C, and iodine. Note the
exception: IRON needs actually DROP during lactation (often below prepregnancy levels) because
menstruation is typically suppressed.
Question 4. Parents ask when to introduce solid foods to their healthy full-term infant. Which
response reflects current recommendations?
A. At 3 months, beginning with honey-sweetened cereal to encourage acceptance
B. At 2 months, starting with diluted cow's milk in a bottle
C. At 6 months, when the infant can sit with support, has good head control, and
shows loss of the extrusion reflex
D. At 12 months, since breast milk or formula alone is adequate for the entire first year
✓ Correct answer: C
Rationale. Complementary foods are introduced around 6 months, guided by developmental
readiness rather than the calendar alone: sitting with support, steady head and neck control,
disappearance of the tongue-thrust (extrusion) reflex, and interest in food. By 6 months, infant iron
stores from birth are depleted, making iron-rich complementary foods important.
Distractor analysis.
A — Honey is CONTRAINDICATED before 12 months due to the risk of infant botulism from Clostridium
botulinum spores; 3 months is also too early developmentally.
B — Cow's milk is not appropriate before 12 months — it causes GI blood loss, is low in iron, and imposes
a high renal solute load.
D — Waiting until 12 months risks iron deficiency and may impair acceptance of textures and self-feeding
skills.
Clinical pearl. Introduce one new single-ingredient food at a time and wait 3-5 days before the next, to
identify allergic reactions. Current guidance actually favors EARLY introduction of allergens such as
peanut (around 4-6 months in high-risk infants) to reduce allergy development — a reversal of older
advice.
Question 5. A nurse assesses a 16-month-old whose parents report he drinks 40 ounces of whole
milk daily and eats very little solid food. Which deficiency is most likely?
