ATI RN Nutrition CMS Proctored
Exam: 100 Practice Questions and
Answer Explanations
Part One: Nutritional Assessment and Screening (1–25)
1. A nurse is screening a client for nutritional risk. Which finding is an early indicator of
protein-calorie malnutrition?
A. Weight loss of 2% over 1 month
B. Serum albumin level of 3.2 g/dL
C. Decreased grip strength
D. Triceps skinfold thickness below the 50th percentile
Answer: C
Explanation: Decreased grip strength is an early and sensitive indicator of protein-calorie
malnutrition, reflecting reduced muscle function before significant anthropometric changes
occur. Albumin has a long half-life and is not an early indicator. Triceps skinfold measures fat
stores, which are depleted later .
2. A nurse is evaluating laboratory results. Which finding indicates a risk for malnutrition?
A. Hemoglobin 14.2 g/dL
B. Prealbumin 12 mg/dL
C. Total lymphocyte count 2,500 cells/mm³
D. Serum transferrin 250 mg/dL
Answer: B
Explanation: Prealbumin has a half-life of 2–3 days and is a sensitive marker for acute
nutritional changes. Normal is 15–36 mg/dL, so 12 mg/dL indicates risk. Lymphocyte count
below 1,500 indicates risk; 2,500 is normal. Transferrin 250 mg/dL is within normal range
(200–360) .
3. Which component is part of the Subjective Global Assessment (SGA)?
A. Serum albumin level
B. Weight history and dietary intake changes
C. Anthropometric measurements only
D. Calculation of nitrogen balance
Answer: B
Explanation: The SGA uses focused history (weight history, dietary intake, GI symptoms,
functional capacity) and brief physical exam. It does not include laboratory values like
albumin or nitrogen balance .
,4. A client weighs 88 kg and is 1.75 meters tall. What is the BMI?
A. 25.1
B. 28.7
C. 30.2
D. 32.4
Answer: B
Explanation: BMI = weight (kg) / height (m)². 88 / (1.75)² = .0625 = 28.7. This falls in
the overweight category (25–29.9) .
5. Which physical examination finding is associated with protein deficiency?
A. Bitot's spots
B. Glossitis
C. Edema
D. Follicular hyperkeratosis
Answer: C
Explanation: Edema is a sign of protein deficiency due to decreased oncotic pressure from
low serum albumin. Bitot's spots are associated with vitamin A deficiency. Glossitis is
associated with B-vitamin deficiencies. Follicular hyperkeratosis is associated with vitamin A
or essential fatty acid deficiency .
6. Which laboratory value best reflects recent nutritional status over the past 2–3 weeks?
A. Serum albumin
B. Serum prealbumin
C. Total lymphocyte count
D. Hemoglobin
Answer: B
Explanation: Prealbumin has a half-life of approximately 2–3 days, making it the most
sensitive indicator of recent nutritional status. Albumin has a half-life of 18–20 days and
reflects longer-term status .
7. A nurse is assessing a client for dehydration. Which finding is most concerning?
A. Moist mucous membranes
B. Clear urine
C. Orthostatic hypotension
D. Increased urine output
Answer: C
Explanation: Orthostatic hypotension occurs when circulating volume is reduced. Other
dehydration signs include dry mucous membranes, concentrated urine, thirst, tachycardia,
and decreased urine output .
8. Which client is at greatest risk for malnutrition?
A. A healthy adult with stable weight
B. A client with prolonged inability to consume adequate food
, C. A client who eats three balanced meals daily
D. A client who drinks adequate fluids
Answer: B
Explanation: Prolonged inadequate intake places a client at high risk for calorie, protein,
vitamin, mineral, and fluid deficiencies .
9. Which question is most appropriate when obtaining a dietary history?
A. "Do you exercise every day?"
B. "What foods and beverages do you typically consume during a normal day?"
C. "What is your favorite food?"
D. "Do you like to cook?"
Answer: B
Explanation: A 24-hour dietary recall or typical daily intake question provides specific
information about types and amounts of food consumed .
10. A client has a BMI of 32. How should the nurse classify this client's weight?
A. Underweight
B. Normal weight
C. Overweight
D. Obese
Answer: D
Explanation: BMI 30 or greater is classified as obese. BMI 25–29.9 is overweight; 18.5–24.9
is normal; below 18.5 is underweight .
11. Which finding indicates a risk for malnutrition?
A. BMI of 23
B. Serum albumin of 2.5 g/dL
C. Prealbumin of 25 mg/dL
D. Hemoglobin of 14 g/dL
Answer: B
Explanation: Serum albumin below 3.5 g/dL indicates malnutrition. Normal albumin is 3.5–
5.0 g/dL. Prealbumin of 25 mg/dL is normal (15–36) .
12. A nurse is assessing hydration status. Which finding indicates dehydration?
A. Moist mucous membranes
B. Urine specific gravity of 1.035
C. Blood pressure 120/80 mm Hg
D. Heart rate 72 bpm
Answer: B
Explanation: Urine specific gravity of 1.035 indicates concentrated urine, a sign of
dehydration. Moist mucous membranes and normal vital signs suggest adequate hydration .
Exam: 100 Practice Questions and
Answer Explanations
Part One: Nutritional Assessment and Screening (1–25)
1. A nurse is screening a client for nutritional risk. Which finding is an early indicator of
protein-calorie malnutrition?
A. Weight loss of 2% over 1 month
B. Serum albumin level of 3.2 g/dL
C. Decreased grip strength
D. Triceps skinfold thickness below the 50th percentile
Answer: C
Explanation: Decreased grip strength is an early and sensitive indicator of protein-calorie
malnutrition, reflecting reduced muscle function before significant anthropometric changes
occur. Albumin has a long half-life and is not an early indicator. Triceps skinfold measures fat
stores, which are depleted later .
2. A nurse is evaluating laboratory results. Which finding indicates a risk for malnutrition?
A. Hemoglobin 14.2 g/dL
B. Prealbumin 12 mg/dL
C. Total lymphocyte count 2,500 cells/mm³
D. Serum transferrin 250 mg/dL
Answer: B
Explanation: Prealbumin has a half-life of 2–3 days and is a sensitive marker for acute
nutritional changes. Normal is 15–36 mg/dL, so 12 mg/dL indicates risk. Lymphocyte count
below 1,500 indicates risk; 2,500 is normal. Transferrin 250 mg/dL is within normal range
(200–360) .
3. Which component is part of the Subjective Global Assessment (SGA)?
A. Serum albumin level
B. Weight history and dietary intake changes
C. Anthropometric measurements only
D. Calculation of nitrogen balance
Answer: B
Explanation: The SGA uses focused history (weight history, dietary intake, GI symptoms,
functional capacity) and brief physical exam. It does not include laboratory values like
albumin or nitrogen balance .
,4. A client weighs 88 kg and is 1.75 meters tall. What is the BMI?
A. 25.1
B. 28.7
C. 30.2
D. 32.4
Answer: B
Explanation: BMI = weight (kg) / height (m)². 88 / (1.75)² = .0625 = 28.7. This falls in
the overweight category (25–29.9) .
5. Which physical examination finding is associated with protein deficiency?
A. Bitot's spots
B. Glossitis
C. Edema
D. Follicular hyperkeratosis
Answer: C
Explanation: Edema is a sign of protein deficiency due to decreased oncotic pressure from
low serum albumin. Bitot's spots are associated with vitamin A deficiency. Glossitis is
associated with B-vitamin deficiencies. Follicular hyperkeratosis is associated with vitamin A
or essential fatty acid deficiency .
6. Which laboratory value best reflects recent nutritional status over the past 2–3 weeks?
A. Serum albumin
B. Serum prealbumin
C. Total lymphocyte count
D. Hemoglobin
Answer: B
Explanation: Prealbumin has a half-life of approximately 2–3 days, making it the most
sensitive indicator of recent nutritional status. Albumin has a half-life of 18–20 days and
reflects longer-term status .
7. A nurse is assessing a client for dehydration. Which finding is most concerning?
A. Moist mucous membranes
B. Clear urine
C. Orthostatic hypotension
D. Increased urine output
Answer: C
Explanation: Orthostatic hypotension occurs when circulating volume is reduced. Other
dehydration signs include dry mucous membranes, concentrated urine, thirst, tachycardia,
and decreased urine output .
8. Which client is at greatest risk for malnutrition?
A. A healthy adult with stable weight
B. A client with prolonged inability to consume adequate food
, C. A client who eats three balanced meals daily
D. A client who drinks adequate fluids
Answer: B
Explanation: Prolonged inadequate intake places a client at high risk for calorie, protein,
vitamin, mineral, and fluid deficiencies .
9. Which question is most appropriate when obtaining a dietary history?
A. "Do you exercise every day?"
B. "What foods and beverages do you typically consume during a normal day?"
C. "What is your favorite food?"
D. "Do you like to cook?"
Answer: B
Explanation: A 24-hour dietary recall or typical daily intake question provides specific
information about types and amounts of food consumed .
10. A client has a BMI of 32. How should the nurse classify this client's weight?
A. Underweight
B. Normal weight
C. Overweight
D. Obese
Answer: D
Explanation: BMI 30 or greater is classified as obese. BMI 25–29.9 is overweight; 18.5–24.9
is normal; below 18.5 is underweight .
11. Which finding indicates a risk for malnutrition?
A. BMI of 23
B. Serum albumin of 2.5 g/dL
C. Prealbumin of 25 mg/dL
D. Hemoglobin of 14 g/dL
Answer: B
Explanation: Serum albumin below 3.5 g/dL indicates malnutrition. Normal albumin is 3.5–
5.0 g/dL. Prealbumin of 25 mg/dL is normal (15–36) .
12. A nurse is assessing hydration status. Which finding indicates dehydration?
A. Moist mucous membranes
B. Urine specific gravity of 1.035
C. Blood pressure 120/80 mm Hg
D. Heart rate 72 bpm
Answer: B
Explanation: Urine specific gravity of 1.035 indicates concentrated urine, a sign of
dehydration. Moist mucous membranes and normal vital signs suggest adequate hydration .
