HESI NUTRITION PROCTORED EXAM
2026 CORRECT VERIFIED ANSWERS
WITH RATIONALES GRADE A+
ACHIEVED | INSTANT DOWNLOAD |
100% PASS GUARANTEE
HESI Nutrition Practice Exam (Latest 2026 Edition)
Question 1
A nurse is caring for a client with chronic kidney disease (CKD) who is
not receiving dialysis. Which dietary modification should the nurse
prioritize to prevent the accumulation of nitrogenous waste products?
A. Increase total daily fluid intake to over 3,000 mL.
B. Restrict dietary sodium intake to less than 500 mg per day.
C. Limit dietary protein intake to high-biological-value
sources.
D. Encourage a high-potassium diet to balance serum electrolytes.
Correct Answer: C
Rationale: In non-dialysis CKD clients, limiting protein intake reduces
nitrogenous waste buildup. High-biological-value proteins (like eggs
and lean meat) provide essential amino acids while minimizing waste.
Question 2
A client with a history of alcohol use disorder is admitted with severe
malnutrition. The healthcare provider orders an intravenous infusion of
dextrose 5% in water with standard vitamins. Which vitamin must the
nurse ensure is administered before or alongside the glucose infusion to
prevent Wernicke-Korsakoff syndrome?
A. Thiamine (Vitamin B1)
B. Pyridoxine (Vitamin B6)
C. Cyanocobalamin (Vitamin B12)
D. Riboflavin (Vitamin B2)
,Correct Answer: A
Rationale: Thiamine is a critical coenzyme for glucose metabolism.
Administering glucose to a thiamine-deficient client can precipitate
acute Wernicke's encephalopathy; therefore, thiamine must be replaced
first.
Question 3
An older adult client residing in a long-term care facility is diagnosed
with a stage 3 pressure injury on the sacrum. Which nutritional
intervention is most appropriate to support tissue healing and collagen
synthesis?
A. Implementing a strict clear liquid diet for 48 hours.
B. Restricting total caloric intake to manage body weight.
C. Increasing dietary protein intake to 1.2 to 1.5 grams per
kilogram of body weight.
D. Supplementing with mega-doses of fat-soluble vitamin A.
Correct Answer: C
Rationale: Wound healing requires increased protein and caloric intake
to rebuild tissues. A range of 1.2 to 1.5 g/kg of protein is standard
clinical practice for managing advanced pressure injuries.
Question 4
A nurse is preparing a discharge teaching plan for a client newly
diagnosed with celiac disease. Which food selection, if chosen by the
client, indicates a correct understanding of a gluten-free diet?
A. Whole wheat couscous with grilled chicken breast.
B. Cream of wheat cereal topped with fresh strawberries.
C. Quinoa salad with mixed vegetables and olive oil.
D. Toasted rye bread with mashed avocado.
Correct Answer: C
Rationale: Quinoa is naturally gluten-free. Wheat, rye, barley, and
couscous contain gluten and must be strictly avoided by individuals
with celiac disease to prevent intestinal villi damage.
Question 5
A client with type 1 diabetes mellitus is learning about carbohydrate
counting to manage postprandial blood glucose levels. The client plans to
eat a meal containing 60 grams of carbohydrates. If the client's insulin-
to-carbohydrate ratio is 1:15, how many units of rapid-acting insulin
should be administered?
,A. 2 units
B. 4 units
C. 6 units
D. 8 units
Correct Answer: B
Rationale: Dividing 60 grams of carbohydrates by the ratio of 15
grams per unit yields 4 units of insulin ( = 4).
Question 6
A nurse is caring for a client receiving total parenteral nutrition (TPN)
via a central venous catheter. The current TPN bag is empty, and the
next bag is delayed from the pharmacy. Which IV solution should the
nurse infuse while waiting to prevent rebound hypoglycemia?
A. 0.9% Sodium Chloride (Normal Saline)
B. 5% Dextrose in 0.45% Sodium Chloride
C. 10% Dextrose in Water (D10W)
D. Lactated Ringer's solution
Correct Answer: C
Rationale: TPN contains high concentrations of dextrose. Abruptly
stopping it can cause insulin levels to remain high, inducing severe
hypoglycemia. Infusing D10W maintains circulating blood glucose until
the next TPN bag arrives.
Question 7
A client is diagnosed with dumping syndrome following a subtotal
gastrectomy. Which dietary instruction should the nurse include in the
client's teaching plan to minimize symptoms?
A. Consume liquids between meals rather than with solid
foods.
B. Eat three large, high-carbohydrate meals per day.
C. Drink a large glass of fruit juice with breakfast.
D. Lie down in a high-Fowler's position immediately after eating.
Correct Answer: A
Rationale: Separating liquids from solids prevents rapid gastric
emptying. Clients should eat small, frequent meals low in simple sugars
and lie down in a recumbent position after meals to slow digestion.
Question 8
A nurse is reviewing the laboratory results of a client who has been
receiving total parenteral nutrition (TPN) for two weeks. The nurse notes
, a gradual increase in liver enzymes (AST and ALT) and serum
triglycerides. Which underlying issue should the nurse suspect?
A. Refeeding syndrome
B. Overfeeding or high carbohydrate infusion rate
C. Essential fatty acid deficiency
D. Acute bacterial sepsis from the central line
Correct Answer: B
Rationale: Excess calorie delivery, particularly via carbohydrates in
TPN, can cause hepatic steatosis (fatty liver) and hypertriglyceridemia.
Adjusting the total caloric or glucose load is typically necessary.
Question 9
An antepartum nurse is counseling a pregnant client in her first
trimester who has an iron-deficiency anemia diagnosis. To maximize the
absorption of prescribed oral iron supplements, the nurse should
instruct the client to take the medication with which fluid?
A. A hot cup of green tea
B. A glass of calcium-fortified whole milk
C. A glass of fresh orange juice
D. An iced decaffeinated coffee
Correct Answer: C
Rationale: Vitamin C (ascorbic acid) significantly enhances the
absorption of non-heme oral iron by reducing it to a more soluble
ferrous state. Calcium, tannins in tea, and polyphenols in coffee inhibit
iron absorption.
Question 10
A client with advanced liver cirrhosis and hepatic encephalopathy
exhibits altered mental status and asterixis. Which dietary management
strategy is most appropriate during an acute exacerbation of hepatic
encephalopathy?
A. Complete restriction of dietary protein indefinitely.
B. Temporary restriction of protein, prioritizing plant-based
and branched-chain amino acids.
C. High-fat, low-carbohydrate ketogenic diet.
D. Severe restriction of sodium to less than 200 mg/day.
Correct Answer: B
Rationale: While severe protein restriction was historically used,
modern guidelines recommend maintaining lean body mass while
2026 CORRECT VERIFIED ANSWERS
WITH RATIONALES GRADE A+
ACHIEVED | INSTANT DOWNLOAD |
100% PASS GUARANTEE
HESI Nutrition Practice Exam (Latest 2026 Edition)
Question 1
A nurse is caring for a client with chronic kidney disease (CKD) who is
not receiving dialysis. Which dietary modification should the nurse
prioritize to prevent the accumulation of nitrogenous waste products?
A. Increase total daily fluid intake to over 3,000 mL.
B. Restrict dietary sodium intake to less than 500 mg per day.
C. Limit dietary protein intake to high-biological-value
sources.
D. Encourage a high-potassium diet to balance serum electrolytes.
Correct Answer: C
Rationale: In non-dialysis CKD clients, limiting protein intake reduces
nitrogenous waste buildup. High-biological-value proteins (like eggs
and lean meat) provide essential amino acids while minimizing waste.
Question 2
A client with a history of alcohol use disorder is admitted with severe
malnutrition. The healthcare provider orders an intravenous infusion of
dextrose 5% in water with standard vitamins. Which vitamin must the
nurse ensure is administered before or alongside the glucose infusion to
prevent Wernicke-Korsakoff syndrome?
A. Thiamine (Vitamin B1)
B. Pyridoxine (Vitamin B6)
C. Cyanocobalamin (Vitamin B12)
D. Riboflavin (Vitamin B2)
,Correct Answer: A
Rationale: Thiamine is a critical coenzyme for glucose metabolism.
Administering glucose to a thiamine-deficient client can precipitate
acute Wernicke's encephalopathy; therefore, thiamine must be replaced
first.
Question 3
An older adult client residing in a long-term care facility is diagnosed
with a stage 3 pressure injury on the sacrum. Which nutritional
intervention is most appropriate to support tissue healing and collagen
synthesis?
A. Implementing a strict clear liquid diet for 48 hours.
B. Restricting total caloric intake to manage body weight.
C. Increasing dietary protein intake to 1.2 to 1.5 grams per
kilogram of body weight.
D. Supplementing with mega-doses of fat-soluble vitamin A.
Correct Answer: C
Rationale: Wound healing requires increased protein and caloric intake
to rebuild tissues. A range of 1.2 to 1.5 g/kg of protein is standard
clinical practice for managing advanced pressure injuries.
Question 4
A nurse is preparing a discharge teaching plan for a client newly
diagnosed with celiac disease. Which food selection, if chosen by the
client, indicates a correct understanding of a gluten-free diet?
A. Whole wheat couscous with grilled chicken breast.
B. Cream of wheat cereal topped with fresh strawberries.
C. Quinoa salad with mixed vegetables and olive oil.
D. Toasted rye bread with mashed avocado.
Correct Answer: C
Rationale: Quinoa is naturally gluten-free. Wheat, rye, barley, and
couscous contain gluten and must be strictly avoided by individuals
with celiac disease to prevent intestinal villi damage.
Question 5
A client with type 1 diabetes mellitus is learning about carbohydrate
counting to manage postprandial blood glucose levels. The client plans to
eat a meal containing 60 grams of carbohydrates. If the client's insulin-
to-carbohydrate ratio is 1:15, how many units of rapid-acting insulin
should be administered?
,A. 2 units
B. 4 units
C. 6 units
D. 8 units
Correct Answer: B
Rationale: Dividing 60 grams of carbohydrates by the ratio of 15
grams per unit yields 4 units of insulin ( = 4).
Question 6
A nurse is caring for a client receiving total parenteral nutrition (TPN)
via a central venous catheter. The current TPN bag is empty, and the
next bag is delayed from the pharmacy. Which IV solution should the
nurse infuse while waiting to prevent rebound hypoglycemia?
A. 0.9% Sodium Chloride (Normal Saline)
B. 5% Dextrose in 0.45% Sodium Chloride
C. 10% Dextrose in Water (D10W)
D. Lactated Ringer's solution
Correct Answer: C
Rationale: TPN contains high concentrations of dextrose. Abruptly
stopping it can cause insulin levels to remain high, inducing severe
hypoglycemia. Infusing D10W maintains circulating blood glucose until
the next TPN bag arrives.
Question 7
A client is diagnosed with dumping syndrome following a subtotal
gastrectomy. Which dietary instruction should the nurse include in the
client's teaching plan to minimize symptoms?
A. Consume liquids between meals rather than with solid
foods.
B. Eat three large, high-carbohydrate meals per day.
C. Drink a large glass of fruit juice with breakfast.
D. Lie down in a high-Fowler's position immediately after eating.
Correct Answer: A
Rationale: Separating liquids from solids prevents rapid gastric
emptying. Clients should eat small, frequent meals low in simple sugars
and lie down in a recumbent position after meals to slow digestion.
Question 8
A nurse is reviewing the laboratory results of a client who has been
receiving total parenteral nutrition (TPN) for two weeks. The nurse notes
, a gradual increase in liver enzymes (AST and ALT) and serum
triglycerides. Which underlying issue should the nurse suspect?
A. Refeeding syndrome
B. Overfeeding or high carbohydrate infusion rate
C. Essential fatty acid deficiency
D. Acute bacterial sepsis from the central line
Correct Answer: B
Rationale: Excess calorie delivery, particularly via carbohydrates in
TPN, can cause hepatic steatosis (fatty liver) and hypertriglyceridemia.
Adjusting the total caloric or glucose load is typically necessary.
Question 9
An antepartum nurse is counseling a pregnant client in her first
trimester who has an iron-deficiency anemia diagnosis. To maximize the
absorption of prescribed oral iron supplements, the nurse should
instruct the client to take the medication with which fluid?
A. A hot cup of green tea
B. A glass of calcium-fortified whole milk
C. A glass of fresh orange juice
D. An iced decaffeinated coffee
Correct Answer: C
Rationale: Vitamin C (ascorbic acid) significantly enhances the
absorption of non-heme oral iron by reducing it to a more soluble
ferrous state. Calcium, tannins in tea, and polyphenols in coffee inhibit
iron absorption.
Question 10
A client with advanced liver cirrhosis and hepatic encephalopathy
exhibits altered mental status and asterixis. Which dietary management
strategy is most appropriate during an acute exacerbation of hepatic
encephalopathy?
A. Complete restriction of dietary protein indefinitely.
B. Temporary restriction of protein, prioritizing plant-based
and branched-chain amino acids.
C. High-fat, low-carbohydrate ketogenic diet.
D. Severe restriction of sodium to less than 200 mg/day.
Correct Answer: B
Rationale: While severe protein restriction was historically used,
modern guidelines recommend maintaining lean body mass while
