Nutrition and Diet Therapy Exam Questions and Answers
with Verified Solutions Latest 2026/2027
Comprehensive Board Review & Clinical Practice Test Bank
Question 1
A client with chronic kidney disease (CKD) Stage 4 is receiving dietary counseling. Which
nutrient intake should be restricted to prevent hyperphosphatemia and bone mineral disorders?
• A) Vitamin C
• B) Soluble fiber
• C) Phosphorus
• D) Monounsaturated fats
Correct Answer: C) Phosphorus
Green Rationale: As kidney function declines, phosphate excretion drops, leading to hyperphosphatemia,
secondary hyperparathyroidism, and renal osteodystrophy. Restricting high-phosphorus foods (dairy,
processed meats, nuts, soft drinks) helps manage serum phosphate levels.
Question 2
Which vitamin deficiency is classically associated with the clinical presentation of pellagra,
characterized by diarrhea, dermatitis, dementia, and death?
• A) Thiamine (Vitamin B1)
• B) Niacin (Vitamin B3)
• C) Pyridoxine (Vitamin B6)
• D) Cobalamin (Vitamin B12)
Correct Answer: B) Niacin (Vitamin B3)
Green Rationale: Niacin deficiency leads to pellagra, characterized by the 4 Ds: dermatitis, diarrhea,
dementia, and death. Thiamine deficiency causes beriberi and Wernicke-Korsakoff syndrome.
Question 3
A client recovering from total gastrectomy is at high risk for developing pernicious anemia.
Which dietary supplement or route of administration will be required lifelong?
• A) Oral folic acid tablets
• B) High-dose oral iron supplements
• C) Intramuscular or high-dose sublingual Vitamin B12
• D) Intravenous Vitamin C therapy
Correct Answer: C) Intramuscular or high-dose sublingual Vitamin B12
Green Rationale: Gastrectomy removes parietal cells responsible for intrinsic factor production. Intrinsic
factor is required for Vitamin B12 absorption in the terminal ileum, so parenteral or sublingual B12 bypasses
the stomach.
Question 4
,Which lipoprotein is responsible for transporting dietary lipids from the intestinal enterocytes
through the lymphatic system into systemic circulation?
• A) Chylomicrons
• B) Very Low-Density Lipoproteins (VLDL)
• C) Low-Density Lipoproteins (LDL)
• D) High-Density Lipoproteins (HDL)
Correct Answer: A) Chylomicrons
Green Rationale: Chylomicrons package exogenous (dietary) triglycerides and cholesterol in intestinal
enterocytes for transport via lymphatics. VLDL carries endogenous triglycerides from the liver.
Question 5
A nurse provides nutritional teaching for a client taking spironolactone for heart failure. Which
food choice should the client be advised to limit due to the risk of hyperkalemia?
• A) White rice
• B) Applesauce
• C) Bananas and avocados
• D) Skinless chicken breast
Correct Answer: C) Bananas and avocados
Green Rationale: Spironolactone is a potassium-sparing diuretic. Consuming potassium-rich foods like
bananas, avocados, spinach, and potatoes elevates the risk of severe hyperkalemia.
Question 6
Which type of dietary fiber dissolves in water to form a gel-like substance in the gastrointestinal
tract, helping lower blood cholesterol and stabilize blood glucose levels?
• A) Soluble fiber
• B) Insoluble fiber
• C) Lignin
• D) Cellulose
Correct Answer: A) Soluble fiber
Green Rationale: Soluble fibers (pectin, gums, beta-glucan found in oats and legumes) bind bile acids and
slow glucose absorption. Insoluble fiber increases stool bulk and transit speed.
Question 7
A severely malnourished client with a history of chronic alcoholism receives aggressive enteral
refeeding. Which electrolyte shift represents the primary hallmark of Refeeding Syndrome?
• A) Severe hypercalcemia
• B) Rapid hypophosphatemia
• C) Marked hyperkalemia
• D) Elevated serum sodium
Correct Answer: B) Rapid hypophosphatemia
Green Rationale: Refeeding triggers insulin surge, driving glucose, phosphate, potassium, and magnesium
into cells. Severe hypophosphatemia can trigger cardiac arrest, respiratory failure, and seizures.
, Question 8
Which essential amino acid must be strictly restricted in the diet of an infant diagnosed with
phenylketonuria (PKU)?
• A) Tyrosine
• B) Tryptophan
• C) Phenylalanine
• D) Leucine
Correct Answer: C) Phenylalanine
Green Rationale: PKU stems from a deficiency in phenylalanine hydroxylase. Unmetabolized phenylalanine
accumulates and causes severe intellectual disability. Tyrosine becomes conditionally essential.
Question 9
Which dietary modification is essential for a client newly diagnosed with celiac disease?
• A) Strict restriction of dietary lactose
• B) Complete elimination of wheat, rye, and barley (gluten)
• C) Low-purine, alkalizing diet
• D) High-protein, fat-restricted diet
Correct Answer: B) Complete elimination of wheat, rye, and barley (gluten)
Green Rationale: Celiac disease is an autoimmune enteropathy triggered by gluten proteins in wheat, rye,
and barley, causing small intestinal villous atrophy and malabsorption.
Question 10
Which mineral deficiency is most commonly linked to impaired wound healing, altered taste
perception (dysgeusia), and delayed growth in children?
• A) Zinc
• B) Copper
• C) Selenium
• D) Iodine
Correct Answer: A) Zinc
Green Rationale: Zinc is an essential cofactor for metalloenzymes involved in tissue repair, DNA synthesis,
immune function, and taste bud receptor maintenance.
Question 11
What is the total caloric content provided by a meals containing 50 grams of carbohydrates, 20
grams of protein, and 10 grams of fat?
• A) 280 kcal
• B) 340 kcal
• C) 370 kcal
• D) 450 kcal
Correct Answer: C) 370 kcal
Green Rationale: Caloric values: Carbohydrate = 4 kcal/g, Protein = 4 kcal/g, Fat = 9 kcal/g. Calculation: (50 x
4) + (20 x 4) + (10 x 9) = 200 + 80 + 90 = 370 kcal.
with Verified Solutions Latest 2026/2027
Comprehensive Board Review & Clinical Practice Test Bank
Question 1
A client with chronic kidney disease (CKD) Stage 4 is receiving dietary counseling. Which
nutrient intake should be restricted to prevent hyperphosphatemia and bone mineral disorders?
• A) Vitamin C
• B) Soluble fiber
• C) Phosphorus
• D) Monounsaturated fats
Correct Answer: C) Phosphorus
Green Rationale: As kidney function declines, phosphate excretion drops, leading to hyperphosphatemia,
secondary hyperparathyroidism, and renal osteodystrophy. Restricting high-phosphorus foods (dairy,
processed meats, nuts, soft drinks) helps manage serum phosphate levels.
Question 2
Which vitamin deficiency is classically associated with the clinical presentation of pellagra,
characterized by diarrhea, dermatitis, dementia, and death?
• A) Thiamine (Vitamin B1)
• B) Niacin (Vitamin B3)
• C) Pyridoxine (Vitamin B6)
• D) Cobalamin (Vitamin B12)
Correct Answer: B) Niacin (Vitamin B3)
Green Rationale: Niacin deficiency leads to pellagra, characterized by the 4 Ds: dermatitis, diarrhea,
dementia, and death. Thiamine deficiency causes beriberi and Wernicke-Korsakoff syndrome.
Question 3
A client recovering from total gastrectomy is at high risk for developing pernicious anemia.
Which dietary supplement or route of administration will be required lifelong?
• A) Oral folic acid tablets
• B) High-dose oral iron supplements
• C) Intramuscular or high-dose sublingual Vitamin B12
• D) Intravenous Vitamin C therapy
Correct Answer: C) Intramuscular or high-dose sublingual Vitamin B12
Green Rationale: Gastrectomy removes parietal cells responsible for intrinsic factor production. Intrinsic
factor is required for Vitamin B12 absorption in the terminal ileum, so parenteral or sublingual B12 bypasses
the stomach.
Question 4
,Which lipoprotein is responsible for transporting dietary lipids from the intestinal enterocytes
through the lymphatic system into systemic circulation?
• A) Chylomicrons
• B) Very Low-Density Lipoproteins (VLDL)
• C) Low-Density Lipoproteins (LDL)
• D) High-Density Lipoproteins (HDL)
Correct Answer: A) Chylomicrons
Green Rationale: Chylomicrons package exogenous (dietary) triglycerides and cholesterol in intestinal
enterocytes for transport via lymphatics. VLDL carries endogenous triglycerides from the liver.
Question 5
A nurse provides nutritional teaching for a client taking spironolactone for heart failure. Which
food choice should the client be advised to limit due to the risk of hyperkalemia?
• A) White rice
• B) Applesauce
• C) Bananas and avocados
• D) Skinless chicken breast
Correct Answer: C) Bananas and avocados
Green Rationale: Spironolactone is a potassium-sparing diuretic. Consuming potassium-rich foods like
bananas, avocados, spinach, and potatoes elevates the risk of severe hyperkalemia.
Question 6
Which type of dietary fiber dissolves in water to form a gel-like substance in the gastrointestinal
tract, helping lower blood cholesterol and stabilize blood glucose levels?
• A) Soluble fiber
• B) Insoluble fiber
• C) Lignin
• D) Cellulose
Correct Answer: A) Soluble fiber
Green Rationale: Soluble fibers (pectin, gums, beta-glucan found in oats and legumes) bind bile acids and
slow glucose absorption. Insoluble fiber increases stool bulk and transit speed.
Question 7
A severely malnourished client with a history of chronic alcoholism receives aggressive enteral
refeeding. Which electrolyte shift represents the primary hallmark of Refeeding Syndrome?
• A) Severe hypercalcemia
• B) Rapid hypophosphatemia
• C) Marked hyperkalemia
• D) Elevated serum sodium
Correct Answer: B) Rapid hypophosphatemia
Green Rationale: Refeeding triggers insulin surge, driving glucose, phosphate, potassium, and magnesium
into cells. Severe hypophosphatemia can trigger cardiac arrest, respiratory failure, and seizures.
, Question 8
Which essential amino acid must be strictly restricted in the diet of an infant diagnosed with
phenylketonuria (PKU)?
• A) Tyrosine
• B) Tryptophan
• C) Phenylalanine
• D) Leucine
Correct Answer: C) Phenylalanine
Green Rationale: PKU stems from a deficiency in phenylalanine hydroxylase. Unmetabolized phenylalanine
accumulates and causes severe intellectual disability. Tyrosine becomes conditionally essential.
Question 9
Which dietary modification is essential for a client newly diagnosed with celiac disease?
• A) Strict restriction of dietary lactose
• B) Complete elimination of wheat, rye, and barley (gluten)
• C) Low-purine, alkalizing diet
• D) High-protein, fat-restricted diet
Correct Answer: B) Complete elimination of wheat, rye, and barley (gluten)
Green Rationale: Celiac disease is an autoimmune enteropathy triggered by gluten proteins in wheat, rye,
and barley, causing small intestinal villous atrophy and malabsorption.
Question 10
Which mineral deficiency is most commonly linked to impaired wound healing, altered taste
perception (dysgeusia), and delayed growth in children?
• A) Zinc
• B) Copper
• C) Selenium
• D) Iodine
Correct Answer: A) Zinc
Green Rationale: Zinc is an essential cofactor for metalloenzymes involved in tissue repair, DNA synthesis,
immune function, and taste bud receptor maintenance.
Question 11
What is the total caloric content provided by a meals containing 50 grams of carbohydrates, 20
grams of protein, and 10 grams of fat?
• A) 280 kcal
• B) 340 kcal
• C) 370 kcal
• D) 450 kcal
Correct Answer: C) 370 kcal
Green Rationale: Caloric values: Carbohydrate = 4 kcal/g, Protein = 4 kcal/g, Fat = 9 kcal/g. Calculation: (50 x
4) + (20 x 4) + (10 x 9) = 200 + 80 + 90 = 370 kcal.
