HESI RN NUTRITION SPECIALITY EXAM
2026/2027 | Newly Released
Actual 55 questions with NGN ,Correct Answers and
Expert Explanations
Q1: Select All That Apply: The nurse is assessing a patient for signs of protein-energy
malnutrition. Which findings support this diagnosis? (Select all that apply.)
A. BMI of 17 [CORRECT]
B. Presence of temporal wasting [CORRECT]
C. Albumin level of 4.5 g/dL
D. Poor wound healing [CORRECT]
E. Complaints of hunger
Correct Answer: A, B, D
Rationale: A BMI of 17 indicates underweight, temporal wasting is a sign of muscle
loss, and poor wound healing is a direct result of protein deficiency. An albumin of 4.5 is
normal, and hunger is not always present in malnutrition (e.g., anorexia).
Q2: Which laboratory value is most useful for evaluating the acute response to
nutritional intervention in a critically ill patient?
A. Albumin
B. Pre-albumin [CORRECT]
C. Transferrin
D. Hemoglobin
Correct Answer: B
Rationale: Pre-albumin has a short half-life of 2 to 3 days, making it a sensitive
indicator of short-term nutritional changes. Albumin (half-life 20 days) is a better
marker for chronic status.
,Q3: The nurse is reviewing a new TPN (Total Parenteral Nutrition) order. Which
intervention is critical to prevent infection?
A. Changing the central line dressing every 12 hours.
B. Using a dedicated lumen for TPN only. [CORRECT]
C. Warming the TPN solution in a microwave.
D. Adding vitamins immediately to the lipid emulsion.
Correct Answer: B
Rationale: A dedicated lumen is crucial to prevent "line sepsis" or precipitates forming
when incompatible drugs are mixed. TPN is usually prepared by pharmacy and should
not be microwaved. Vitamins should be added to the amino acid solution, not lipids, just
before administration. Dressings are changed every 5-7 days per protocol unless soiled.
Q4: A patient is receiving continuous tube feeding. The nurse checks the gastric residual
volume (GRV) and obtains 300 mL. The institutional protocol specifies holding the
feeding if the GRV is > 250 mL. What is the nurse’s first action?
A. Slow the rate of the feeding.
B. Hold the feeding and notify the provider. [CORRECT]
C. Elevate the head of the bed to 90 degrees.
D. Administer a prokinetic agent.
Correct Answer: B
Rationale: The nurse must follow the institutional protocol. Since 300 mL exceeds the
threshold of 250 mL, the feeding must be held to prevent aspiration, and the provider
should be notified for further instructions (e.g., restarting at a lower rate, evaluating for
obstruction).
Q5: A patient with Chronic Kidney Disease (CKD) stage 3 asks for a snack. Which food
choice is most appropriate given their dietary restrictions?
A. Apple
B. Banana
C. Cheese stick
D. Orange juice [PILOT]
, Correct Answer: A
Rationale: Patients with CKD often need to restrict potassium (bananas, oranges) and
phosphorus (dairy/cheese). Apples are lower in potassium and phosphorus, making
them a safer choice.
Q6: The nurse is teaching a patient with hypertension about the DASH (Dietary
Approaches to Stop Hypertension) diet. Which food should the nurse encourage the
patient to limit?
A. Fresh carrots
B. Skim milk
C. Canned soup [CORRECT]
D. Brown rice
Correct Answer: C
Rationale: Canned soups are notoriously high in sodium, which is restricted in the
DASH diet (limit to 2300 mg/day, ideally 1500 mg). Vegetables, low-fat dairy, and
whole grains are emphasized.
Q7: Select All That Apply: A patient with diabetes is experiencing hypoglycemia. Which
clinical manifestations should the nurse expect to find? (Select all that apply.)
A. Diaphoresis [CORRECT]
B. Tremors [CORRECT]
C. Polyuria
D. Confusion [CORRECT]
E. Dry skin
Correct Answer: A, B, D
Rationale: The classic signs of hypoglycemia include adrenergic symptoms (sweating,
tremors) and neuroglycopenic symptoms (confusion). Polyuria is a sign of
hyperglycemia. Dry skin is not an acute sign of hypoglycemia.
2026/2027 | Newly Released
Actual 55 questions with NGN ,Correct Answers and
Expert Explanations
Q1: Select All That Apply: The nurse is assessing a patient for signs of protein-energy
malnutrition. Which findings support this diagnosis? (Select all that apply.)
A. BMI of 17 [CORRECT]
B. Presence of temporal wasting [CORRECT]
C. Albumin level of 4.5 g/dL
D. Poor wound healing [CORRECT]
E. Complaints of hunger
Correct Answer: A, B, D
Rationale: A BMI of 17 indicates underweight, temporal wasting is a sign of muscle
loss, and poor wound healing is a direct result of protein deficiency. An albumin of 4.5 is
normal, and hunger is not always present in malnutrition (e.g., anorexia).
Q2: Which laboratory value is most useful for evaluating the acute response to
nutritional intervention in a critically ill patient?
A. Albumin
B. Pre-albumin [CORRECT]
C. Transferrin
D. Hemoglobin
Correct Answer: B
Rationale: Pre-albumin has a short half-life of 2 to 3 days, making it a sensitive
indicator of short-term nutritional changes. Albumin (half-life 20 days) is a better
marker for chronic status.
,Q3: The nurse is reviewing a new TPN (Total Parenteral Nutrition) order. Which
intervention is critical to prevent infection?
A. Changing the central line dressing every 12 hours.
B. Using a dedicated lumen for TPN only. [CORRECT]
C. Warming the TPN solution in a microwave.
D. Adding vitamins immediately to the lipid emulsion.
Correct Answer: B
Rationale: A dedicated lumen is crucial to prevent "line sepsis" or precipitates forming
when incompatible drugs are mixed. TPN is usually prepared by pharmacy and should
not be microwaved. Vitamins should be added to the amino acid solution, not lipids, just
before administration. Dressings are changed every 5-7 days per protocol unless soiled.
Q4: A patient is receiving continuous tube feeding. The nurse checks the gastric residual
volume (GRV) and obtains 300 mL. The institutional protocol specifies holding the
feeding if the GRV is > 250 mL. What is the nurse’s first action?
A. Slow the rate of the feeding.
B. Hold the feeding and notify the provider. [CORRECT]
C. Elevate the head of the bed to 90 degrees.
D. Administer a prokinetic agent.
Correct Answer: B
Rationale: The nurse must follow the institutional protocol. Since 300 mL exceeds the
threshold of 250 mL, the feeding must be held to prevent aspiration, and the provider
should be notified for further instructions (e.g., restarting at a lower rate, evaluating for
obstruction).
Q5: A patient with Chronic Kidney Disease (CKD) stage 3 asks for a snack. Which food
choice is most appropriate given their dietary restrictions?
A. Apple
B. Banana
C. Cheese stick
D. Orange juice [PILOT]
, Correct Answer: A
Rationale: Patients with CKD often need to restrict potassium (bananas, oranges) and
phosphorus (dairy/cheese). Apples are lower in potassium and phosphorus, making
them a safer choice.
Q6: The nurse is teaching a patient with hypertension about the DASH (Dietary
Approaches to Stop Hypertension) diet. Which food should the nurse encourage the
patient to limit?
A. Fresh carrots
B. Skim milk
C. Canned soup [CORRECT]
D. Brown rice
Correct Answer: C
Rationale: Canned soups are notoriously high in sodium, which is restricted in the
DASH diet (limit to 2300 mg/day, ideally 1500 mg). Vegetables, low-fat dairy, and
whole grains are emphasized.
Q7: Select All That Apply: A patient with diabetes is experiencing hypoglycemia. Which
clinical manifestations should the nurse expect to find? (Select all that apply.)
A. Diaphoresis [CORRECT]
B. Tremors [CORRECT]
C. Polyuria
D. Confusion [CORRECT]
E. Dry skin
Correct Answer: A, B, D
Rationale: The classic signs of hypoglycemia include adrenergic symptoms (sweating,
tremors) and neuroglycopenic symptoms (confusion). Polyuria is a sign of
hyperglycemia. Dry skin is not an acute sign of hypoglycemia.
