Latest HESI RN Nutrition 2026 with NGN | Comprehensive
Questions and Answers
Introduction
This comprehensive examination is meticulously designed to align with the 2026 HESI RN
Nutrition blueprint, integrating Next Generation NCLEX (NGN) style questions to assess critical
thinking and clinical judgment. The exam covers a broad spectrum of nutritional concepts
essential for safe and effective nursing practice, including macronutrients and micronutrients,
therapeutic diets, nutritional assessment, enteral and parenteral nutrition, and nutritional
considerations across the lifespan and in various disease states. Each of the 1000 questions is
followed by multiple correct answers and a detailed rationale to enhance learning and reinforce
evidence-based practice. This resource serves as an invaluable tool for nursing students
preparing for the HESI exit exam and the NCLEX-RN.
1. A nurse is providing dietary teaching to a client with a new diagnosis of celiac disease.
Which of the following foods should the nurse instruct the client to avoid?
A) Rice
B) Corn
C) Barley
D) Quinoa
E) Oats (unless specifically labeled gluten-free)
F) Millet
Rationale: Celiac disease requires a strict lifelong gluten-free diet. Gluten is a protein found in
wheat, barley, rye, and triticale. Oats are often contaminated with wheat during processing, so
only oats specifically labeled gluten-free are safe. Rice, corn, quinoa, and millet are gluten-free
grains and are safe for consumption.
2. A nurse is calculating the body mass index (BMI) of a client who weighs 75 kg and is 1.7
meters tall. Which of the following is the client's BMI?
A) 22.1
B) 24.9
C) 25.9
D) 27.3
E) 29.4
F) 31.2
,Rationale: BMI is calculated as weight in kilograms divided by height in meters squared. 75 kg /
(1.7 m)^2 = .89 = 25.95, which rounds to 25.9. A BMI of 25.9 falls into the overweight
category (25-29.9).
3. A nurse is assessing a client who is at risk for malnutrition. Which of the following
findings should the nurse identify as an early indicator of protein-calorie malnutrition?
A) Edema
B) Weight loss of 2% over one week
C) Hair loss
D) Muscle wasting
E) Dry, scaly skin
F) Decreased serum albumin
Rationale: Unintentional weight loss, even a small percentage like 2% in one week, is an early
and significant indicator of protein-calorie malnutrition. Edema, hair loss, muscle wasting, dry
skin, and decreased serum albumin are later signs of more severe malnutrition.
4. A client who is receiving total parenteral nutrition (TPN) exhibits symptoms of
hyperglycemia. Which of the following interventions should the nurse anticipate?
A) Decrease the TPN rate
B) Add insulin to the TPN solution
C) Administer subcutaneous insulin
D) Increase the TPN rate
E) Discontinue TPN immediately
F) Change the TPN to a lipid emulsion
Rationale: Hyperglycemia is a common complication of TPN due to the high dextrose
concentration. Interventions include administering subcutaneous insulin or adding insulin to the
TPN solution. Decreasing the rate might be considered but not as a sole intervention.
Discontinuing TPN abruptly is dangerous and can cause hypoglycemia.
5. A nurse is educating a client about a low-sodium diet to manage hypertension. Which of
the following foods should the nurse recommend the client choose? (Select all that
apply)
A) Fresh fruits and vegetables
B) Canned soups
C) Processed meats
D) Unsalted nuts
E) Fresh poultry
F) Frozen dinners
,Rationale: Fresh fruits, vegetables, unsalted nuts, and fresh poultry are naturally low in sodium.
Canned soups, processed meats, and frozen dinners are typically high in sodium due to
processing and preservatives.
6. A client is 24 hours post-operative following a gastrectomy and is receiving a clear liquid
diet. Which of the following items should the nurse include on the client's tray?
A) Milk
B) Orange juice with pulp
C) Chicken broth
D) Cream of wheat
E) Gelatin
F) Apple juice
Rationale: A clear liquid diet consists of foods that are liquid at room temperature and leave
minimal residue in the gastrointestinal tract. Examples include clear broth, gelatin, apple juice
(without pulp), and strained fruit juices. Milk, orange juice with pulp, and cream of wheat are
not appropriate for a clear liquid diet.
7. A nurse is monitoring a client with heart failure who has been prescribed a 2-gram
sodium diet. Which breakfast selection by the client indicates a need for further
teaching?
A) Scrambled eggs with fresh tomatoes
B) Oatmeal with banana slices
C) Cornflakes with milk
D) Bacon and toast
E) Yogurt with berries
F) Whole wheat toast with jam
Rationale: Bacon is a processed meat that is extremely high in sodium and should be avoided
on a low-sodium diet. The other options are lower in sodium and more appropriate choices.
8. A nurse is assessing a client's nutritional status. Which laboratory value is most indicative
of a client's short-term nutritional status?
A) Serum albumin
B) Serum prealbumin
C) Transferrin
D) Total protein
E) Hemoglobin
F) Creatinine
Rationale: Prealbumin has a short half-life (2-3 days) and decreases rapidly with inadequate
protein intake, making it a sensitive indicator of short-term (acute) nutritional changes. Albumin
has a longer half-life (18-20 days) and reflects long-term protein status.
, 9. A client is prescribed warfarin (Coumadin) and is being discharged. The nurse should
instruct the client to maintain a consistent intake of which vitamin?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin D
E) Vitamin E
F) Vitamin K
Rationale: Warfarin is a vitamin K antagonist. A sudden increase in dietary vitamin K (found in
green leafy vegetables) can counteract the effects of warfarin and decrease the INR, increasing
the risk of clot formation. A consistent daily intake of vitamin K is crucial for maintaining stable
anticoagulation.
10. A nurse is caring for a client with chronic kidney disease who is on a protein-restricted
diet. Which of the following proteins is considered a high biological value protein and
should be included in the diet?
A) Beans
B) Rice
C) Eggs
D) Bread
E) Pasta
F) Nuts
Rationale: High biological value proteins contain all essential amino acids and are efficiently
used by the body. Eggs are an excellent source of high-quality protein. Plant-based proteins like
beans, rice, bread, pasta, and nuts are often incomplete proteins and may be restricted on a
renal diet to limit non-essential amino acids.
11. A nurse is providing teaching about fat-soluble vitamins to a group of nursing students.
Which vitamins are classified as fat-soluble? (Select all that apply)
A) Vitamin A
B) Vitamin B1 (Thiamine)
C) Vitamin C (Ascorbic acid)
D) Vitamin D
E) Vitamin E
F) Vitamin K
Rationale: Vitamins A, D, E, and K are fat-soluble vitamins. They are absorbed with dietary fats
and can be stored in the body's adipose tissue and liver. B vitamins and vitamin C are water-
soluble vitamins.
Questions and Answers
Introduction
This comprehensive examination is meticulously designed to align with the 2026 HESI RN
Nutrition blueprint, integrating Next Generation NCLEX (NGN) style questions to assess critical
thinking and clinical judgment. The exam covers a broad spectrum of nutritional concepts
essential for safe and effective nursing practice, including macronutrients and micronutrients,
therapeutic diets, nutritional assessment, enteral and parenteral nutrition, and nutritional
considerations across the lifespan and in various disease states. Each of the 1000 questions is
followed by multiple correct answers and a detailed rationale to enhance learning and reinforce
evidence-based practice. This resource serves as an invaluable tool for nursing students
preparing for the HESI exit exam and the NCLEX-RN.
1. A nurse is providing dietary teaching to a client with a new diagnosis of celiac disease.
Which of the following foods should the nurse instruct the client to avoid?
A) Rice
B) Corn
C) Barley
D) Quinoa
E) Oats (unless specifically labeled gluten-free)
F) Millet
Rationale: Celiac disease requires a strict lifelong gluten-free diet. Gluten is a protein found in
wheat, barley, rye, and triticale. Oats are often contaminated with wheat during processing, so
only oats specifically labeled gluten-free are safe. Rice, corn, quinoa, and millet are gluten-free
grains and are safe for consumption.
2. A nurse is calculating the body mass index (BMI) of a client who weighs 75 kg and is 1.7
meters tall. Which of the following is the client's BMI?
A) 22.1
B) 24.9
C) 25.9
D) 27.3
E) 29.4
F) 31.2
,Rationale: BMI is calculated as weight in kilograms divided by height in meters squared. 75 kg /
(1.7 m)^2 = .89 = 25.95, which rounds to 25.9. A BMI of 25.9 falls into the overweight
category (25-29.9).
3. A nurse is assessing a client who is at risk for malnutrition. Which of the following
findings should the nurse identify as an early indicator of protein-calorie malnutrition?
A) Edema
B) Weight loss of 2% over one week
C) Hair loss
D) Muscle wasting
E) Dry, scaly skin
F) Decreased serum albumin
Rationale: Unintentional weight loss, even a small percentage like 2% in one week, is an early
and significant indicator of protein-calorie malnutrition. Edema, hair loss, muscle wasting, dry
skin, and decreased serum albumin are later signs of more severe malnutrition.
4. A client who is receiving total parenteral nutrition (TPN) exhibits symptoms of
hyperglycemia. Which of the following interventions should the nurse anticipate?
A) Decrease the TPN rate
B) Add insulin to the TPN solution
C) Administer subcutaneous insulin
D) Increase the TPN rate
E) Discontinue TPN immediately
F) Change the TPN to a lipid emulsion
Rationale: Hyperglycemia is a common complication of TPN due to the high dextrose
concentration. Interventions include administering subcutaneous insulin or adding insulin to the
TPN solution. Decreasing the rate might be considered but not as a sole intervention.
Discontinuing TPN abruptly is dangerous and can cause hypoglycemia.
5. A nurse is educating a client about a low-sodium diet to manage hypertension. Which of
the following foods should the nurse recommend the client choose? (Select all that
apply)
A) Fresh fruits and vegetables
B) Canned soups
C) Processed meats
D) Unsalted nuts
E) Fresh poultry
F) Frozen dinners
,Rationale: Fresh fruits, vegetables, unsalted nuts, and fresh poultry are naturally low in sodium.
Canned soups, processed meats, and frozen dinners are typically high in sodium due to
processing and preservatives.
6. A client is 24 hours post-operative following a gastrectomy and is receiving a clear liquid
diet. Which of the following items should the nurse include on the client's tray?
A) Milk
B) Orange juice with pulp
C) Chicken broth
D) Cream of wheat
E) Gelatin
F) Apple juice
Rationale: A clear liquid diet consists of foods that are liquid at room temperature and leave
minimal residue in the gastrointestinal tract. Examples include clear broth, gelatin, apple juice
(without pulp), and strained fruit juices. Milk, orange juice with pulp, and cream of wheat are
not appropriate for a clear liquid diet.
7. A nurse is monitoring a client with heart failure who has been prescribed a 2-gram
sodium diet. Which breakfast selection by the client indicates a need for further
teaching?
A) Scrambled eggs with fresh tomatoes
B) Oatmeal with banana slices
C) Cornflakes with milk
D) Bacon and toast
E) Yogurt with berries
F) Whole wheat toast with jam
Rationale: Bacon is a processed meat that is extremely high in sodium and should be avoided
on a low-sodium diet. The other options are lower in sodium and more appropriate choices.
8. A nurse is assessing a client's nutritional status. Which laboratory value is most indicative
of a client's short-term nutritional status?
A) Serum albumin
B) Serum prealbumin
C) Transferrin
D) Total protein
E) Hemoglobin
F) Creatinine
Rationale: Prealbumin has a short half-life (2-3 days) and decreases rapidly with inadequate
protein intake, making it a sensitive indicator of short-term (acute) nutritional changes. Albumin
has a longer half-life (18-20 days) and reflects long-term protein status.
, 9. A client is prescribed warfarin (Coumadin) and is being discharged. The nurse should
instruct the client to maintain a consistent intake of which vitamin?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin D
E) Vitamin E
F) Vitamin K
Rationale: Warfarin is a vitamin K antagonist. A sudden increase in dietary vitamin K (found in
green leafy vegetables) can counteract the effects of warfarin and decrease the INR, increasing
the risk of clot formation. A consistent daily intake of vitamin K is crucial for maintaining stable
anticoagulation.
10. A nurse is caring for a client with chronic kidney disease who is on a protein-restricted
diet. Which of the following proteins is considered a high biological value protein and
should be included in the diet?
A) Beans
B) Rice
C) Eggs
D) Bread
E) Pasta
F) Nuts
Rationale: High biological value proteins contain all essential amino acids and are efficiently
used by the body. Eggs are an excellent source of high-quality protein. Plant-based proteins like
beans, rice, bread, pasta, and nuts are often incomplete proteins and may be restricted on a
renal diet to limit non-essential amino acids.
11. A nurse is providing teaching about fat-soluble vitamins to a group of nursing students.
Which vitamins are classified as fat-soluble? (Select all that apply)
A) Vitamin A
B) Vitamin B1 (Thiamine)
C) Vitamin C (Ascorbic acid)
D) Vitamin D
E) Vitamin E
F) Vitamin K
Rationale: Vitamins A, D, E, and K are fat-soluble vitamins. They are absorbed with dietary fats
and can be stored in the body's adipose tissue and liver. B vitamins and vitamin C are water-
soluble vitamins.
