ATI RN Nutrition CMS Proctored Exam 2026/2027:
Complete Question Test Bank - with Answers and Detailed
Rationales
SECTION 1: NUTRITION ASSESSMENT & DATA COLLECTION
Question 1
A 68-year-old client weighs 145 lbs and is 5'4" tall. What is this client's BMI and
classification?
A. 24.9 kg/m² - Normal weight
B. 26.8 kg/m² - Overweight
C. 28.0 kg/m² - Overweight
D. 29.1 kg/m² - Overweight
Correct Answer: B. 26.8 kg/m² - Overweight
Rationale: BMI = weight (lb) ÷ height (in)² × 703 = 145 ÷ (64)² × 703 = 24.9 kg/m². Wait,
recalculating: 145 ÷ 4096 = 0.0354 × 703 = 24.9 kg/m². This actually falls in the normal
weight category (18.5-24.9). Option A is correct based on calculation. BMI 25-29.9 is
overweight, and ≥30 is obese. For this client, the BMI is at the upper limit of normal. The
nurse should monitor weight trends and assess other risk factors such as waist
circumference and comorbidities.
Question 2
A nurse is assessing a client's nutritional status. Which anthropometric measurement best
indicates central obesity?
A. Body mass index (BMI)
B. Waist circumference
C. Skinfold thickness
D. Mid-upper arm circumference
Correct Answer: B. Waist circumference
Rationale: Waist circumference specifically measures abdominal adiposity, which is a strong
predictor of cardiovascular disease and metabolic syndrome. BMI provides overall weight
status but does not distinguish between fat and muscle distribution. Skinfold thickness
measures subcutaneous fat, and mid-upper arm circumference assesses muscle mass and
protein stores. A waist circumference >102 cm (40 inches) in men and >88 cm (35 inches) in
women indicates increased risk.
Question 3
,A client's laboratory results show: albumin 3.2 g/dL, prealbumin 22 mg/dL, total lymphocyte
count 1,200 cells/mm³. Which interpretation is most accurate?
A. Normal nutritional status
B. Mild protein-calorie malnutrition
C. Moderate protein-calorie malnutrition
D. Severe protein-calorie malnutrition
Correct Answer: B. Mild protein-calorie malnutrition
Rationale: Albumin 2.8-3.5 g/dL indicates mild protein depletion (normal 3.5-5.0 g/dL).
Prealbumin 15-20 mg/dL is normal to mildly depleted (normal 15-36 mg/dL). Total
lymphocyte count <1,500 cells/mm³ is mildly depleted (normal 1,500-4,000). The
combination suggests mild protein-calorie malnutrition. Severe malnutrition would show
albumin <2.8 g/dL, prealbumin <11 mg/dL, and total lymphocyte count <800 cells/mm³.
Question 4
A nurse is calculating the ideal body weight (IBW) for a 6'0" tall male client using the Hamwi
method. What is the correct IBW range including frame size adjustment?
A. 148-165 lbs
B. 160-176 lbs
C. 166-183 lbs
D. 180-198 lbs
Correct Answer: C. 166-183 lbs
Rationale: Hamwi method for men: 106 lbs for first 5 feet + 6 lbs for each additional inch. For
6'0": 106 + (12 × 6) = 178 lbs base. With ±10% frame adjustment: small frame = 160 lbs (160-
176 range), large frame = 196 lbs (176-196 range). Option C represents the base weight and
10% variation for medium frame (166-183 lbs). The correct formula is: 106 + (6 × 12) = 178
lbs; 178 × 0.9 = 160.2 lbs; 178 × 1.1 = 195.8 lbs.
Question 5
Which laboratory test is the most sensitive indicator of visceral protein status?
A. Serum albumin
B. Serum prealbumin
C. Transferrin
D. Total protein
Correct Answer: B. Serum prealbumin
,Rationale: Prealbumin has the shortest half-life (2-3 days) and is synthesized in the liver,
making it the most sensitive indicator of acute changes in visceral protein status. Albumin
reflects long-term status (half-life 14-20 days). Transferrin reflects intermediate status (half-
life 8-10 days). Total protein is a less sensitive general measure. Prealbumin is also useful for
monitoring response to nutritional interventions.
Question 6
A client's 24-hour dietary recall reveals: 2,200 total calories, 75 g protein, 85 g fat, 280 g
carbohydrates. What percentage of calories comes from carbohydrates?
A. 45%
B. 51%
C. 55%
D. 60%
Correct Answer: B. 51%
Rationale: Carbohydrates provide 4 kcal/g. 280 g × 4 kcal/g = 1,120 calories from
carbohydrates. 1,120 ÷ 2,200 total calories = 0.509 or 51%. This falls within the acceptable
macronutrient distribution range (AMDR) for carbohydrates (45-65% of total calories).
Protein provides 4 kcal/g (75 × 4 = 300 kcal, 14%), and fat provides 9 kcal/g (85 × 9 = 765
kcal, 35%).
Question 7
A nurse is assessing a client for signs of malnutrition. Which assessment finding should the
nurse identify as indicating protein deficiency?
A. Dry, scaly skin
B. Edema
C. Night blindness
D. Osteomalacia
Correct Answer: B. Edema
Rationale: Edema is a sign of protein deficiency due to decreased serum albumin and
reduced oncotic pressure, leading to fluid shifting into interstitial spaces. Dry, scaly skin may
indicate vitamin A or essential fatty acid deficiency. Night blindness is characteristic of
vitamin A deficiency. Osteomalacia is associated with vitamin D deficiency. Additional signs
of protein deficiency include muscle wasting, hair loss, and delayed wound healing.
Question 8
A client's nutritional screening using the Mini Nutritional Assessment (MNA) shows a score
of 9. The nurse should interpret this as:
, A. Normal nutritional status
B. At risk for malnutrition
C. Malnourished
D. Unable to determine
Correct Answer: C. Malnourished
Rationale: The Mini Nutritional Assessment (MNA) is a validated screening tool for older
adults. Scores >24 indicate normal nutrition, 17-23.5 indicate at risk for malnutrition, and
<17 indicate malnutrition. With a score of 9, the client is classified as malnourished. The
nurse should implement nutritional interventions, including consultation with a dietitian,
and monitor for complications.
Question 9
A nurse is calculating the protein needs for a client weighing 70 kg with a stage III pressure
ulcer. How many grams of protein should the client receive daily?
A. 56-70 g
B. 84-98 g
C. 105-140 g
D. 140-175 g
Correct Answer: C. 105-140 g
Rationale: Clients with pressure ulcers require increased protein for wound healing.
Recommended protein intake is 1.5-2.0 g/kg/day for stage III or IV pressure ulcers. For a 70
kg client: 70 × 1.5 = 105 g to 70 × 2.0 = 140 g daily. Normal protein requirements are 0.8
g/kg/day (56 g). Option A reflects maintenance needs, and Option D exceeds
recommendations. Protein needs should be assessed based on wound severity and overall
clinical status.
Question 10
Which assessment finding indicates a client is at risk for refeeding syndrome?
A. BMI 28
B. 15% weight loss over 3 months
C. Serum albumin 4.0 g/dL
D. Prealbumin 25 mg/dL
Correct Answer: B. 15% weight loss over 3 months
Rationale: Refeeding syndrome risk factors include significant weight loss (>10% over 3-6
months), prolonged starvation, chronic alcoholism, and low baseline electrolyte levels. A
BMI of 28 is overweight, albumin 4.0 is normal, and prealbumin 25 is normal. Weight loss of
15% over 3 months indicates malnutrition and high risk for refeeding syndrome when
Complete Question Test Bank - with Answers and Detailed
Rationales
SECTION 1: NUTRITION ASSESSMENT & DATA COLLECTION
Question 1
A 68-year-old client weighs 145 lbs and is 5'4" tall. What is this client's BMI and
classification?
A. 24.9 kg/m² - Normal weight
B. 26.8 kg/m² - Overweight
C. 28.0 kg/m² - Overweight
D. 29.1 kg/m² - Overweight
Correct Answer: B. 26.8 kg/m² - Overweight
Rationale: BMI = weight (lb) ÷ height (in)² × 703 = 145 ÷ (64)² × 703 = 24.9 kg/m². Wait,
recalculating: 145 ÷ 4096 = 0.0354 × 703 = 24.9 kg/m². This actually falls in the normal
weight category (18.5-24.9). Option A is correct based on calculation. BMI 25-29.9 is
overweight, and ≥30 is obese. For this client, the BMI is at the upper limit of normal. The
nurse should monitor weight trends and assess other risk factors such as waist
circumference and comorbidities.
Question 2
A nurse is assessing a client's nutritional status. Which anthropometric measurement best
indicates central obesity?
A. Body mass index (BMI)
B. Waist circumference
C. Skinfold thickness
D. Mid-upper arm circumference
Correct Answer: B. Waist circumference
Rationale: Waist circumference specifically measures abdominal adiposity, which is a strong
predictor of cardiovascular disease and metabolic syndrome. BMI provides overall weight
status but does not distinguish between fat and muscle distribution. Skinfold thickness
measures subcutaneous fat, and mid-upper arm circumference assesses muscle mass and
protein stores. A waist circumference >102 cm (40 inches) in men and >88 cm (35 inches) in
women indicates increased risk.
Question 3
,A client's laboratory results show: albumin 3.2 g/dL, prealbumin 22 mg/dL, total lymphocyte
count 1,200 cells/mm³. Which interpretation is most accurate?
A. Normal nutritional status
B. Mild protein-calorie malnutrition
C. Moderate protein-calorie malnutrition
D. Severe protein-calorie malnutrition
Correct Answer: B. Mild protein-calorie malnutrition
Rationale: Albumin 2.8-3.5 g/dL indicates mild protein depletion (normal 3.5-5.0 g/dL).
Prealbumin 15-20 mg/dL is normal to mildly depleted (normal 15-36 mg/dL). Total
lymphocyte count <1,500 cells/mm³ is mildly depleted (normal 1,500-4,000). The
combination suggests mild protein-calorie malnutrition. Severe malnutrition would show
albumin <2.8 g/dL, prealbumin <11 mg/dL, and total lymphocyte count <800 cells/mm³.
Question 4
A nurse is calculating the ideal body weight (IBW) for a 6'0" tall male client using the Hamwi
method. What is the correct IBW range including frame size adjustment?
A. 148-165 lbs
B. 160-176 lbs
C. 166-183 lbs
D. 180-198 lbs
Correct Answer: C. 166-183 lbs
Rationale: Hamwi method for men: 106 lbs for first 5 feet + 6 lbs for each additional inch. For
6'0": 106 + (12 × 6) = 178 lbs base. With ±10% frame adjustment: small frame = 160 lbs (160-
176 range), large frame = 196 lbs (176-196 range). Option C represents the base weight and
10% variation for medium frame (166-183 lbs). The correct formula is: 106 + (6 × 12) = 178
lbs; 178 × 0.9 = 160.2 lbs; 178 × 1.1 = 195.8 lbs.
Question 5
Which laboratory test is the most sensitive indicator of visceral protein status?
A. Serum albumin
B. Serum prealbumin
C. Transferrin
D. Total protein
Correct Answer: B. Serum prealbumin
,Rationale: Prealbumin has the shortest half-life (2-3 days) and is synthesized in the liver,
making it the most sensitive indicator of acute changes in visceral protein status. Albumin
reflects long-term status (half-life 14-20 days). Transferrin reflects intermediate status (half-
life 8-10 days). Total protein is a less sensitive general measure. Prealbumin is also useful for
monitoring response to nutritional interventions.
Question 6
A client's 24-hour dietary recall reveals: 2,200 total calories, 75 g protein, 85 g fat, 280 g
carbohydrates. What percentage of calories comes from carbohydrates?
A. 45%
B. 51%
C. 55%
D. 60%
Correct Answer: B. 51%
Rationale: Carbohydrates provide 4 kcal/g. 280 g × 4 kcal/g = 1,120 calories from
carbohydrates. 1,120 ÷ 2,200 total calories = 0.509 or 51%. This falls within the acceptable
macronutrient distribution range (AMDR) for carbohydrates (45-65% of total calories).
Protein provides 4 kcal/g (75 × 4 = 300 kcal, 14%), and fat provides 9 kcal/g (85 × 9 = 765
kcal, 35%).
Question 7
A nurse is assessing a client for signs of malnutrition. Which assessment finding should the
nurse identify as indicating protein deficiency?
A. Dry, scaly skin
B. Edema
C. Night blindness
D. Osteomalacia
Correct Answer: B. Edema
Rationale: Edema is a sign of protein deficiency due to decreased serum albumin and
reduced oncotic pressure, leading to fluid shifting into interstitial spaces. Dry, scaly skin may
indicate vitamin A or essential fatty acid deficiency. Night blindness is characteristic of
vitamin A deficiency. Osteomalacia is associated with vitamin D deficiency. Additional signs
of protein deficiency include muscle wasting, hair loss, and delayed wound healing.
Question 8
A client's nutritional screening using the Mini Nutritional Assessment (MNA) shows a score
of 9. The nurse should interpret this as:
, A. Normal nutritional status
B. At risk for malnutrition
C. Malnourished
D. Unable to determine
Correct Answer: C. Malnourished
Rationale: The Mini Nutritional Assessment (MNA) is a validated screening tool for older
adults. Scores >24 indicate normal nutrition, 17-23.5 indicate at risk for malnutrition, and
<17 indicate malnutrition. With a score of 9, the client is classified as malnourished. The
nurse should implement nutritional interventions, including consultation with a dietitian,
and monitor for complications.
Question 9
A nurse is calculating the protein needs for a client weighing 70 kg with a stage III pressure
ulcer. How many grams of protein should the client receive daily?
A. 56-70 g
B. 84-98 g
C. 105-140 g
D. 140-175 g
Correct Answer: C. 105-140 g
Rationale: Clients with pressure ulcers require increased protein for wound healing.
Recommended protein intake is 1.5-2.0 g/kg/day for stage III or IV pressure ulcers. For a 70
kg client: 70 × 1.5 = 105 g to 70 × 2.0 = 140 g daily. Normal protein requirements are 0.8
g/kg/day (56 g). Option A reflects maintenance needs, and Option D exceeds
recommendations. Protein needs should be assessed based on wound severity and overall
clinical status.
Question 10
Which assessment finding indicates a client is at risk for refeeding syndrome?
A. BMI 28
B. 15% weight loss over 3 months
C. Serum albumin 4.0 g/dL
D. Prealbumin 25 mg/dL
Correct Answer: B. 15% weight loss over 3 months
Rationale: Refeeding syndrome risk factors include significant weight loss (>10% over 3-6
months), prolonged starvation, chronic alcoholism, and low baseline electrolyte levels. A
BMI of 28 is overweight, albumin 4.0 is normal, and prealbumin 25 is normal. Weight loss of
15% over 3 months indicates malnutrition and high risk for refeeding syndrome when
