WGU D440 HESI Nutrition Objective Assessment – Western
Governors University (WGU)
SECTION I: MACRONUTRIENTS – CARBOHYDRATES, PROTEINS, AND FATS
Question 1
A nurse is teaching a client with type 2 diabetes mellitus about carbohydrate
counting. Which statement by the client indicates a correct understanding of the
teaching?
A. "I should eliminate all carbohydrates from my diet to control my blood sugar."
B. "I need to count total carbohydrates, including sugars and starches, at each
meal."
C. "Only simple sugars affect my blood glucose levels."
D. "I can eat unlimited amounts of non-starchy vegetables because they have no
carbohydrates."
Correct Answer: B
Rationale: Carbohydrate counting is a meal planning approach that involves
tracking the total grams of carbohydrates consumed at each meal, including both
simple sugars and complex starches. Carbohydrates have the most significant
impact on postprandial blood glucose levels. Eliminating all carbohydrates (A) is
not recommended and can lead to hypoglycemia and nutritional deficiencies.
Both simple and complex carbohydrates affect blood glucose (C). Non-starchy
vegetables do contain carbohydrates, though in smaller amounts (D).
Question 2
Which macronutrient provides 9 calories per gram and is essential for hormone
production and cell membrane integrity?
A. Carbohydrates
B. Proteins
C. Fats
D. Alcohol
, Correct Answer: C
Rationale: Fats provide 9 calories per gram, the most energy-dense
macronutrient. Fats are essential for hormone synthesis, cell membrane
structure, insulation, and absorption of fat-soluble vitamins (A, D, E, K).
Carbohydrates and proteins each provide 4 calories per gram. Alcohol provides 7
calories per gram but is not considered a macronutrient.
Question 3
A client's laboratory results show a serum albumin level of 2.8 g/dL (normal: 3.5-
5.0 g/dL). This finding is most consistent with which condition?
A. Dehydration
B. Protein-energy malnutrition
C. Hyperlipidemia
D. Iron deficiency anemia
Correct Answer: B
Rationale: Serum albumin is a protein synthesized by the liver and serves as a
marker of visceral protein status. A low serum albumin level (below 3.5 g/dL)
indicates protein-energy malnutrition, which can result from inadequate protein
intake, impaired synthesis, or increased protein loss. Dehydration would cause a
falsely elevated albumin (A). Hyperlipidemia (C) and iron deficiency anemia (D) do
not directly cause low albumin.
Question 4
Which of the following foods is considered a complete protein source?
A. Black beans
B. Brown rice
C. Eggs
D. Peanut butter
Correct Answer: C
, Rationale: Complete proteins contain all nine essential amino acids in
adequate amounts. Eggs are a complete protein source, providing high biological
value protein. Black beans (A), brown rice (B), and peanut butter (D) are
incomplete proteins, lacking one or more essential amino acids. Combining
incomplete proteins (e.g., beans and rice) can create a complementary protein.
Question 5
A nurse is providing dietary teaching to a client who is at risk for cardiovascular
disease. Which type of fat should the nurse recommend the client limit most
strictly?
A. Monounsaturated fats
B. Polyunsaturated fats
C. Trans fats
D. Omega-3 fatty acids
Correct Answer: C
Rationale: Trans fats (partially hydrogenated oils) are the most harmful type
of dietary fat, increasing LDL cholesterol while decreasing HDL cholesterol,
thereby significantly increasing cardiovascular disease risk. Monounsaturated fats
(A) and polyunsaturated fats (B) are heart-healthy fats. Omega-3 fatty acids (D)
have anti-inflammatory properties and are beneficial for cardiovascular health.
Question 6
What is the recommended daily fiber intake for an adult female according to the
Dietary Guidelines?
A. 15 grams
B. 25 grams
C. 35 grams
D. 45 grams
Correct Answer: B
, Rationale: The recommended daily fiber intake is 25 grams for adult women
and 38 grams for adult men. Fiber is essential for digestive health, blood glucose
regulation, and cholesterol management. Intake of 15 grams (A) is insufficient,
while 35-45 grams (C, D) exceeds the general recommendation unless specifically
indicated.
Question 7
A client with celiac disease should avoid which of the following foods? (Select all
that apply)
A. Wheat bread
B. Barley soup
C. Rye crackers
D. Corn tortillas
E. Rice cakes
Correct Answer: A, B, C
Rationale: Celiac disease requires strict avoidance of gluten, which is found in
wheat, barley, and rye. Wheat bread (A), barley soup (B), and rye crackers (C) all
contain gluten and must be avoided. Corn tortillas (D) and rice cakes (E) are
naturally gluten-free and safe for clients with celiac disease.
Question 8
Which laboratory value is the best indicator of long-term glycemic control in a
client with diabetes mellitus?
A. Fasting blood glucose
B. Hemoglobin A1C
C. Random blood glucose
D. Oral glucose tolerance test
Correct Answer: B
Governors University (WGU)
SECTION I: MACRONUTRIENTS – CARBOHYDRATES, PROTEINS, AND FATS
Question 1
A nurse is teaching a client with type 2 diabetes mellitus about carbohydrate
counting. Which statement by the client indicates a correct understanding of the
teaching?
A. "I should eliminate all carbohydrates from my diet to control my blood sugar."
B. "I need to count total carbohydrates, including sugars and starches, at each
meal."
C. "Only simple sugars affect my blood glucose levels."
D. "I can eat unlimited amounts of non-starchy vegetables because they have no
carbohydrates."
Correct Answer: B
Rationale: Carbohydrate counting is a meal planning approach that involves
tracking the total grams of carbohydrates consumed at each meal, including both
simple sugars and complex starches. Carbohydrates have the most significant
impact on postprandial blood glucose levels. Eliminating all carbohydrates (A) is
not recommended and can lead to hypoglycemia and nutritional deficiencies.
Both simple and complex carbohydrates affect blood glucose (C). Non-starchy
vegetables do contain carbohydrates, though in smaller amounts (D).
Question 2
Which macronutrient provides 9 calories per gram and is essential for hormone
production and cell membrane integrity?
A. Carbohydrates
B. Proteins
C. Fats
D. Alcohol
, Correct Answer: C
Rationale: Fats provide 9 calories per gram, the most energy-dense
macronutrient. Fats are essential for hormone synthesis, cell membrane
structure, insulation, and absorption of fat-soluble vitamins (A, D, E, K).
Carbohydrates and proteins each provide 4 calories per gram. Alcohol provides 7
calories per gram but is not considered a macronutrient.
Question 3
A client's laboratory results show a serum albumin level of 2.8 g/dL (normal: 3.5-
5.0 g/dL). This finding is most consistent with which condition?
A. Dehydration
B. Protein-energy malnutrition
C. Hyperlipidemia
D. Iron deficiency anemia
Correct Answer: B
Rationale: Serum albumin is a protein synthesized by the liver and serves as a
marker of visceral protein status. A low serum albumin level (below 3.5 g/dL)
indicates protein-energy malnutrition, which can result from inadequate protein
intake, impaired synthesis, or increased protein loss. Dehydration would cause a
falsely elevated albumin (A). Hyperlipidemia (C) and iron deficiency anemia (D) do
not directly cause low albumin.
Question 4
Which of the following foods is considered a complete protein source?
A. Black beans
B. Brown rice
C. Eggs
D. Peanut butter
Correct Answer: C
, Rationale: Complete proteins contain all nine essential amino acids in
adequate amounts. Eggs are a complete protein source, providing high biological
value protein. Black beans (A), brown rice (B), and peanut butter (D) are
incomplete proteins, lacking one or more essential amino acids. Combining
incomplete proteins (e.g., beans and rice) can create a complementary protein.
Question 5
A nurse is providing dietary teaching to a client who is at risk for cardiovascular
disease. Which type of fat should the nurse recommend the client limit most
strictly?
A. Monounsaturated fats
B. Polyunsaturated fats
C. Trans fats
D. Omega-3 fatty acids
Correct Answer: C
Rationale: Trans fats (partially hydrogenated oils) are the most harmful type
of dietary fat, increasing LDL cholesterol while decreasing HDL cholesterol,
thereby significantly increasing cardiovascular disease risk. Monounsaturated fats
(A) and polyunsaturated fats (B) are heart-healthy fats. Omega-3 fatty acids (D)
have anti-inflammatory properties and are beneficial for cardiovascular health.
Question 6
What is the recommended daily fiber intake for an adult female according to the
Dietary Guidelines?
A. 15 grams
B. 25 grams
C. 35 grams
D. 45 grams
Correct Answer: B
, Rationale: The recommended daily fiber intake is 25 grams for adult women
and 38 grams for adult men. Fiber is essential for digestive health, blood glucose
regulation, and cholesterol management. Intake of 15 grams (A) is insufficient,
while 35-45 grams (C, D) exceeds the general recommendation unless specifically
indicated.
Question 7
A client with celiac disease should avoid which of the following foods? (Select all
that apply)
A. Wheat bread
B. Barley soup
C. Rye crackers
D. Corn tortillas
E. Rice cakes
Correct Answer: A, B, C
Rationale: Celiac disease requires strict avoidance of gluten, which is found in
wheat, barley, and rye. Wheat bread (A), barley soup (B), and rye crackers (C) all
contain gluten and must be avoided. Corn tortillas (D) and rice cakes (E) are
naturally gluten-free and safe for clients with celiac disease.
Question 8
Which laboratory value is the best indicator of long-term glycemic control in a
client with diabetes mellitus?
A. Fasting blood glucose
B. Hemoglobin A1C
C. Random blood glucose
D. Oral glucose tolerance test
Correct Answer: B
