WGU D440 HESI Nutrition Objective
Assessment – Western Governors
University (WGU) – 2026/2027
Academic Year – Verified Questions
and Answers for Healthcare and
Nursing Students
Question 1
A 45-year-old male with a history of chronic alcoholism presents with confusion,
nystagmus, and ataxia. The clinical team suspects
Wernicke-Korsakoff syndrome. Which of the following coenzymes is deficient in this
patient?
A. Flavin adenine dinucleotide (FAD)
B. Pyridoxal phosphate (PLP)
C. Thiamine pyrophosphate (TPP)
D. Nicotinamide adenine dinucleotide (NAD)
Rationale: Wernicke-Korsakoff syndrome is caused by a severe deficiency of thiamine
(vitamin B1). Thiamine pyrophosphate (TPP) is the active coenzyme required for critical
metabolic pathways, including the pyruvate dehydrogenase complex and the alpha-
,ketoglutarate dehydrogenase complex. Chronic alcohol use impairs thiamine absorption
and utilization, leading to these classic neurological symptoms .
Question 2
A registered dietitian is evaluating an 82-year-old resident in a long-term care facility
who has developed a deep Stage 3 pressure injury. Which of the following structural
amino acids is conditionally essential under these metabolic stress conditions to
promote collagen synthesis and wound healing?
A. Arginine
B. Alanine
C. Valine
D. Leucine
Rationale: Arginine is a conditionally essential amino acid. While the body can typically
synthesize it in sufficient quantities under normal metabolic conditions, severe tissue
injury, trauma, or major wounds increase the physiological demand beyond the body's
synthetic capacity. Arginine serves as a precursor to proline, which is vital for collagen
synthesis and tissue repair .
Question 3
A patient presents with peripheral edema, tachycardia, and cardiomegaly. The medical
history reveals a diet consisting almost exclusively of polished white rice. Which classical
nutritional deficiency state is demonstrated?
, A. Wet beriberi
B. Dry beriberi
C. Pellagra
D. Scurvy
Rationale: Wet beriberi is the cardiovascular manifestation of severe thiamine (vitamin
B1) deficiency, characterized by high-output heart failure, peripheral vasodilation, and
severe edema. Dry beriberi presents primarily with neurological deficits. Polished rice
lacks the thiamine-rich outer bran layer .
Question 4
An infant is born at 32 weeks of gestation. Due to the immaturity of the liver and low
stores of fat-soluble vitamins, the newborn is at an elevated risk of hemorrhagic disease
of the newborn. Which vitamin must be administered intramuscularly at birth?
A. Vitamin A
B. Vitamin E
C. Vitamin D
D. Vitamin K
Rationale: Newborns have low tissue stores of vitamin K because placental transfer is
poor and their sterile intestinal tracts lack the bacteria necessary to synthesize it. Vitamin
K is a necessary cofactor for the gamma-carboxylation of clotting factors II, VII, IX, and X;
thus, an injection is given at birth to prevent hemorrhagic disease .
Question 5
Assessment – Western Governors
University (WGU) – 2026/2027
Academic Year – Verified Questions
and Answers for Healthcare and
Nursing Students
Question 1
A 45-year-old male with a history of chronic alcoholism presents with confusion,
nystagmus, and ataxia. The clinical team suspects
Wernicke-Korsakoff syndrome. Which of the following coenzymes is deficient in this
patient?
A. Flavin adenine dinucleotide (FAD)
B. Pyridoxal phosphate (PLP)
C. Thiamine pyrophosphate (TPP)
D. Nicotinamide adenine dinucleotide (NAD)
Rationale: Wernicke-Korsakoff syndrome is caused by a severe deficiency of thiamine
(vitamin B1). Thiamine pyrophosphate (TPP) is the active coenzyme required for critical
metabolic pathways, including the pyruvate dehydrogenase complex and the alpha-
,ketoglutarate dehydrogenase complex. Chronic alcohol use impairs thiamine absorption
and utilization, leading to these classic neurological symptoms .
Question 2
A registered dietitian is evaluating an 82-year-old resident in a long-term care facility
who has developed a deep Stage 3 pressure injury. Which of the following structural
amino acids is conditionally essential under these metabolic stress conditions to
promote collagen synthesis and wound healing?
A. Arginine
B. Alanine
C. Valine
D. Leucine
Rationale: Arginine is a conditionally essential amino acid. While the body can typically
synthesize it in sufficient quantities under normal metabolic conditions, severe tissue
injury, trauma, or major wounds increase the physiological demand beyond the body's
synthetic capacity. Arginine serves as a precursor to proline, which is vital for collagen
synthesis and tissue repair .
Question 3
A patient presents with peripheral edema, tachycardia, and cardiomegaly. The medical
history reveals a diet consisting almost exclusively of polished white rice. Which classical
nutritional deficiency state is demonstrated?
, A. Wet beriberi
B. Dry beriberi
C. Pellagra
D. Scurvy
Rationale: Wet beriberi is the cardiovascular manifestation of severe thiamine (vitamin
B1) deficiency, characterized by high-output heart failure, peripheral vasodilation, and
severe edema. Dry beriberi presents primarily with neurological deficits. Polished rice
lacks the thiamine-rich outer bran layer .
Question 4
An infant is born at 32 weeks of gestation. Due to the immaturity of the liver and low
stores of fat-soluble vitamins, the newborn is at an elevated risk of hemorrhagic disease
of the newborn. Which vitamin must be administered intramuscularly at birth?
A. Vitamin A
B. Vitamin E
C. Vitamin D
D. Vitamin K
Rationale: Newborns have low tissue stores of vitamin K because placental transfer is
poor and their sterile intestinal tracts lack the bacteria necessary to synthesize it. Vitamin
K is a necessary cofactor for the gamma-carboxylation of clotting factors II, VII, IX, and X;
thus, an injection is given at birth to prevent hemorrhagic disease .
Question 5
