HESI NUTRITION ACTUAL EXAM 140 QUESTION AND
CORRECT DETAILED ANSWERS WITH RATIONALES
RATED A GRADE.
While a nurse is teaching a client with diabetes about food choices, the client
states, "I do not like broccoli." Which food should the nurse suggest to substitute
for broccoli?
Green beans
Peas
Corn
Mashed potatoes
CORRECT ANSWER: Green beans
Expert Rationale: According to exchange lists for meal planning, green beans and
broccoli are equivalent vegetable substitutes. Both are non-starchy vegetables with
similar carbohydrate, calorie, and nutrient profiles, making them interchangeable in a
diabetic meal plan. Peas are considered a starch exchange because they contain more
carbohydrates than non-starchy vegetables, making them not an equivalent substitute
for broccoli. Corn is classified as a starch exchange due to its higher carbohydrate
content, which would significantly alter the blood glucose response compared to
broccoli. Mashed potatoes are also a starch exchange and contain substantially more
carbohydrates than broccoli, making them an inappropriate substitute for a client with
diabetes who needs to maintain consistent carbohydrate intake.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Diabetes Meal Planning
MSC: HESI — Nutrition
An older adult is returned to the surgical unit after having a subtotal gastrectomy.
Which dietary modification should the nurse anticipate that the healthcare
provider will most likely prescribe?
Small feedings
, Low roughage diet
Clear liquid diet
Diet as tolerated
CORRECT ANSWER: Small feedings
Expert Rationale: Small, frequent feedings are tolerated best after a subtotal
gastrectomy because the stomach's capacity is reduced and the digestive process is
altered. This approach helps prevent dumping syndrome and allows for adequate
nutrition without overwhelming the reduced gastric reservoir. Roughage may be
irritating to the gastrointestinal (GI) tract after surgery and should be avoided initially. As
soon as edema subsides, the individual generally is given small amounts of fluid, and
then the diet is progressed gradually. Allowing only personal food preferences does not
ensure inclusion of nutrients necessary for recovery, and a clear liquid diet would not
provide adequate nutrition for healing.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Postoperative Care
MSC: HESI — Nutrition
A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-
protein diet and IV fluids with vitamins have been prescribed. When implementing
these prescriptions, which goal is the nurse trying to achieve?
Reduce colonic irritation
Reduce gastric acidity
Increase intestinal absorption
Reduce infection rate
CORRECT ANSWER: Reduce colonic irritation
Expert Rationale: A low-residue diet is designed to reduce colonic irritation, motility,
and spasticity by minimizing the amount of undigested fiber and other materials that
pass through the colon. This allows the bowel to rest and reduces inflammation.
Reduction of gastric acidity is the aim of bland diets used in the treatment of gastric
ulcers, not ulcerative colitis. Reducing colonic irritation, motility, and spasticity hopefully
will increase, not reduce, intestinal absorption by allowing the inflamed mucosa to heal.
This diet is designed to allow the bowel to rest, not to reduce infection rates.
, DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Ulcerative Colitis
MSC: HESI — Nutrition
Which food should be avoided by a client who is prescribed monoamine oxidase
inhibitors (MAOIs)?
Bologna
Potatoes
Citrus fruits
Grapefruit juice
CORRECT ANSWER: Bologna
Expert Rationale: Bologna has a high tyramine content, which should not be consumed
by clients taking monoamine oxidase inhibitors (MAOIs) because the drug interaction
may cause severe hypertension, potentially leading to a hypertensive crisis. Tyramine is
found in aged, cured, fermented, or spoiled foods. Potatoes and citrus fruits do not
contain tyramine and are generally safe for clients taking MAOIs. Grapefruit juice may
cause a negative drug interaction in clients taking other medications such as buspirone,
but it is not specifically contraindicated with MAOIs due to tyramine content.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Drug-Nutrient Interactions
MSC: HESI — Nutrition
A child has been diagnosed with celiac disease. The nurse teaches the parents that
the child must follow a gluten-free diet:
Lifelong
Only during childhood
Until symptoms resolve
For one year
CORRECT ANSWER: Lifelong
, Expert Rationale: The diet must continue to be followed because the child will always
have an absence of peptidase, the enzyme needed to metabolize gluten. Celiac disease
is a permanent autoimmune condition, and exposure to gluten will continue to cause
intestinal damage regardless of symptom resolution. Each phase of child development
may have problems related to dietary management, so follow-up care is needed to
prevent crises. A restricted diet is never easy to follow, especially for a growing child, but
gluten must be avoided for a prolonged period and indefinitely for optimal health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Celiac Disease
MSC: HESI — Nutrition
A client with a history of a pulmonary embolus is to receive 3 mg of warfarin daily.
The client has blood drawn twice weekly to ascertain that the international
normalized ratio (INR) stays within a therapeutic range. The nurse provides dietary
teaching. Which food selected by the client indicates that further teaching is
necessary?
Spinach
Eggs
Yellow vegetables
Dairy products and bread
CORRECT ANSWER: Spinach
Expert Rationale: Dark green, leafy vegetables such as spinach are high in vitamin K,
which is the antidote for warfarin. Influencing the level of vitamin K alters the activity of
warfarin because vitamin K acts as a catalyst in the liver for the production of blood-
clotting factors and prothrombin. The intake of foods containing vitamin K must be
consistent to regulate the warfarin dose so that the INR remains within the therapeutic
range. Eggs contain protein and are permitted on the diet. Yellow vegetables contain
vitamin A and are permitted on the diet. Dairy products containing protein and bread
supplying carbohydrates are permitted on the diet.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Drug-Nutrient Interactions
MSC: HESI — Nutrition
CORRECT DETAILED ANSWERS WITH RATIONALES
RATED A GRADE.
While a nurse is teaching a client with diabetes about food choices, the client
states, "I do not like broccoli." Which food should the nurse suggest to substitute
for broccoli?
Green beans
Peas
Corn
Mashed potatoes
CORRECT ANSWER: Green beans
Expert Rationale: According to exchange lists for meal planning, green beans and
broccoli are equivalent vegetable substitutes. Both are non-starchy vegetables with
similar carbohydrate, calorie, and nutrient profiles, making them interchangeable in a
diabetic meal plan. Peas are considered a starch exchange because they contain more
carbohydrates than non-starchy vegetables, making them not an equivalent substitute
for broccoli. Corn is classified as a starch exchange due to its higher carbohydrate
content, which would significantly alter the blood glucose response compared to
broccoli. Mashed potatoes are also a starch exchange and contain substantially more
carbohydrates than broccoli, making them an inappropriate substitute for a client with
diabetes who needs to maintain consistent carbohydrate intake.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Diabetes Meal Planning
MSC: HESI — Nutrition
An older adult is returned to the surgical unit after having a subtotal gastrectomy.
Which dietary modification should the nurse anticipate that the healthcare
provider will most likely prescribe?
Small feedings
, Low roughage diet
Clear liquid diet
Diet as tolerated
CORRECT ANSWER: Small feedings
Expert Rationale: Small, frequent feedings are tolerated best after a subtotal
gastrectomy because the stomach's capacity is reduced and the digestive process is
altered. This approach helps prevent dumping syndrome and allows for adequate
nutrition without overwhelming the reduced gastric reservoir. Roughage may be
irritating to the gastrointestinal (GI) tract after surgery and should be avoided initially. As
soon as edema subsides, the individual generally is given small amounts of fluid, and
then the diet is progressed gradually. Allowing only personal food preferences does not
ensure inclusion of nutrients necessary for recovery, and a clear liquid diet would not
provide adequate nutrition for healing.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Postoperative Care
MSC: HESI — Nutrition
A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-
protein diet and IV fluids with vitamins have been prescribed. When implementing
these prescriptions, which goal is the nurse trying to achieve?
Reduce colonic irritation
Reduce gastric acidity
Increase intestinal absorption
Reduce infection rate
CORRECT ANSWER: Reduce colonic irritation
Expert Rationale: A low-residue diet is designed to reduce colonic irritation, motility,
and spasticity by minimizing the amount of undigested fiber and other materials that
pass through the colon. This allows the bowel to rest and reduces inflammation.
Reduction of gastric acidity is the aim of bland diets used in the treatment of gastric
ulcers, not ulcerative colitis. Reducing colonic irritation, motility, and spasticity hopefully
will increase, not reduce, intestinal absorption by allowing the inflamed mucosa to heal.
This diet is designed to allow the bowel to rest, not to reduce infection rates.
, DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Ulcerative Colitis
MSC: HESI — Nutrition
Which food should be avoided by a client who is prescribed monoamine oxidase
inhibitors (MAOIs)?
Bologna
Potatoes
Citrus fruits
Grapefruit juice
CORRECT ANSWER: Bologna
Expert Rationale: Bologna has a high tyramine content, which should not be consumed
by clients taking monoamine oxidase inhibitors (MAOIs) because the drug interaction
may cause severe hypertension, potentially leading to a hypertensive crisis. Tyramine is
found in aged, cured, fermented, or spoiled foods. Potatoes and citrus fruits do not
contain tyramine and are generally safe for clients taking MAOIs. Grapefruit juice may
cause a negative drug interaction in clients taking other medications such as buspirone,
but it is not specifically contraindicated with MAOIs due to tyramine content.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Drug-Nutrient Interactions
MSC: HESI — Nutrition
A child has been diagnosed with celiac disease. The nurse teaches the parents that
the child must follow a gluten-free diet:
Lifelong
Only during childhood
Until symptoms resolve
For one year
CORRECT ANSWER: Lifelong
, Expert Rationale: The diet must continue to be followed because the child will always
have an absence of peptidase, the enzyme needed to metabolize gluten. Celiac disease
is a permanent autoimmune condition, and exposure to gluten will continue to cause
intestinal damage regardless of symptom resolution. Each phase of child development
may have problems related to dietary management, so follow-up care is needed to
prevent crises. A restricted diet is never easy to follow, especially for a growing child, but
gluten must be avoided for a prolonged period and indefinitely for optimal health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nutrition — Celiac Disease
MSC: HESI — Nutrition
A client with a history of a pulmonary embolus is to receive 3 mg of warfarin daily.
The client has blood drawn twice weekly to ascertain that the international
normalized ratio (INR) stays within a therapeutic range. The nurse provides dietary
teaching. Which food selected by the client indicates that further teaching is
necessary?
Spinach
Eggs
Yellow vegetables
Dairy products and bread
CORRECT ANSWER: Spinach
Expert Rationale: Dark green, leafy vegetables such as spinach are high in vitamin K,
which is the antidote for warfarin. Influencing the level of vitamin K alters the activity of
warfarin because vitamin K acts as a catalyst in the liver for the production of blood-
clotting factors and prothrombin. The intake of foods containing vitamin K must be
consistent to regulate the warfarin dose so that the INR remains within the therapeutic
range. Eggs contain protein and are permitted on the diet. Yellow vegetables contain
vitamin A and are permitted on the diet. Dairy products containing protein and bread
supplying carbohydrates are permitted on the diet.
DIF: Cognitive Level: Apply (Application)
TOP: Nutrition — Drug-Nutrient Interactions
MSC: HESI — Nutrition
