Nr 228 Final Exam Preparation Real Exam
Questions And Correct Answers Actual Exam
2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Nutrition Fundamentals and Macronutrients
Q1: A patient is keeping a food journal and asks how many calories come from the fat she
eats. How many kilocalories are provided by one gram of fat?
A. 4 kcal per gram
B. 7 kcal per gram
C. 9 kcal per gram [CORRECT]
D. 12 kcal per gram
Correct Answer: C
Rationale: Fat is the most energy-dense of the macronutrients at 9 kilocalories per gram,
compared with 4 for both carbohydrate and protein. That density is exactly why high-fat
meals add up so quickly in a daily calorie count.
Q2: A student nurse is tracing the path of carbohydrate digestion through the body. Where
does the digestion of carbohydrate begin?
A. In the stomach, with hydrochloric acid
B. In the mouth, with salivary amylase [CORRECT]
C. In the small intestine, with pancreatic amylase
D. In the large intestine, with bacterial flora
Correct Answer: B
Rationale: Carbohydrate digestion starts in the mouth, where salivary amylase begins
breaking starch into smaller sugars. Stomach acid actually pauses that process, and
pancreatic amylase picks it up again in the small intestine.
Q3: A patient who follows a vegan diet tells the nurse she is worried about getting
"complete protein" without meat. Which food combination should the nurse recommend?
A. Rice and beans [CORRECT]
B. Apple slices with orange juice
C. White bread with strawberry jam
D. Carrot sticks with celery
Correct Answer: A
Rationale: Rice and beans are complementary proteins — together they supply all the
essential amino acids that neither food provides alone. Plant-based diets do not need
animal foods; they just need smart pairings like this one spread across the day.
,Q4: A postoperative patient is eating well and his incision is healing normally. The nurse
recognizes that this patient's nitrogen balance should be:
A. Negative, because tissue is breaking down
B. Unchanged from before surgery
C. In perfect equilibrium
D. Positive, reflecting tissue building and repair [CORRECT]
Correct Answer: D
Rationale: Healing tissue is actively building new protein, so a well-nourished postoperative
patient should show a positive nitrogen balance — intake exceeding output. This matches
the principle of anabolism during recovery.
Q5: A patient with constipation asks the nurse which dietary change will help the most.
Which recommendation is best?
A. Increase soluble fiber and limit water
B. Increase insoluble fiber and drink plenty of fluids [CORRECT]
C. Switch to a clear liquid diet for two weeks
D. Add more simple sugars to the diet
Correct Answer: B
Rationale: Insoluble fiber adds bulk to the stool and stimulates peristalsis, and it needs
adequate fluid to work properly — exactly what a constipated patient requires. Soluble fiber
is gentler and is the better choice for diarrhea or glucose control.
Q6: Which nutrient is the preferred and primary fuel source for the brain?
A. Glucose [CORRECT]
B. Amino acids
C. Fatty acids
D. Fiber
Correct Answer: A
Rationale: Glucose is the fuel the brain runs on, and red blood cells depend on it as well.
Even during fasting, the body works hard to produce enough glucose to keep the brain
supplied.
Q7: While reviewing digestion with a patient, the nurse explains that dietary fat must first
be emulsified before enzymes can break it down. Which substance performs this job?
A. Pepsin
B. Amylase
C. Bile [CORRECT]
D. Insulin
Correct Answer: C
Rationale: Bile, produced by the liver and stored in the gallbladder, emulsifies fat into small
droplets so digestive enzymes can reach it. Without that emulsification, fatty meals are
poorly digested and often cause cramping and loose stools.
Q8: A patient on a very-low-carbohydrate diet tells the nurse that his breath has developed
a fruity odor. What does this finding indicate?
A. Dehydration from fluid restriction
B. Poor dental hygiene
, C. Excess protein storage
D. Ketone production from incomplete fat metabolism [CORRECT]
Correct Answer: D
Rationale: Fruity-smelling breath is a hallmark of ketosis, which develops when
carbohydrate intake is so low that fat is burned incompletely and ketones accumulate. The
body needs a minimum amount of carbohydrate to metabolize fat cleanly.
Q9: Which of the following factors increases a person's basal metabolic rate?
A. Aging
B. Fever [CORRECT]
C. Prolonged calorie restriction
D. A sedentary lifestyle
Correct Answer: B
Rationale: Fever raises the metabolic rate — roughly 7 percent for every degree Fahrenheit
— so calorie and fluid needs climb during illness. Aging, dieting, and inactivity all work in the
opposite direction, lowering metabolic needs.
Q10: A patient's evening snack contains 10 grams of carbohydrate, 5 grams of protein, and 5
grams of fat. How many total kilocalories does this snack provide?
A. 85 kcal
B. 95 kcal
C. 105 kcal [CORRECT]
D. 125 kcal
Correct Answer: C
Rationale: Multiply each gram by its energy value — 10 g carbohydrate times 4, 5 g protein
times 4, and 5 g fat times 9 — which totals 105 kilocalories. This quick math is a handy skill
when teaching patients to read labels.
Q11: A patient with elevated LDL cholesterol asks the nurse which fat he should use for
cooking. Which is the best choice?
A. Olive oil [CORRECT]
B. Butter
C. Stick margarine
D. Coconut oil
Correct Answer: A
Rationale: Olive oil is rich in monounsaturated fat, which helps lower LDL cholesterol when
it replaces saturated fat in the diet. Butter, stick margarine, and coconut oil are all high in
saturated or trans fats.
Q12: A patient with prediabetes asks why whole-grain bread is a better choice than white
bread. Which explanation by the nurse is best?
A. Whole-grain bread has fewer total calories
B. It tastes better than white bread
C. It contains more sodium than white bread
D. Its fiber slows digestion and produces a gradual rise in blood glucose [CORRECT]
Correct Answer: D
Questions And Correct Answers Actual Exam
2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Nutrition Fundamentals and Macronutrients
Q1: A patient is keeping a food journal and asks how many calories come from the fat she
eats. How many kilocalories are provided by one gram of fat?
A. 4 kcal per gram
B. 7 kcal per gram
C. 9 kcal per gram [CORRECT]
D. 12 kcal per gram
Correct Answer: C
Rationale: Fat is the most energy-dense of the macronutrients at 9 kilocalories per gram,
compared with 4 for both carbohydrate and protein. That density is exactly why high-fat
meals add up so quickly in a daily calorie count.
Q2: A student nurse is tracing the path of carbohydrate digestion through the body. Where
does the digestion of carbohydrate begin?
A. In the stomach, with hydrochloric acid
B. In the mouth, with salivary amylase [CORRECT]
C. In the small intestine, with pancreatic amylase
D. In the large intestine, with bacterial flora
Correct Answer: B
Rationale: Carbohydrate digestion starts in the mouth, where salivary amylase begins
breaking starch into smaller sugars. Stomach acid actually pauses that process, and
pancreatic amylase picks it up again in the small intestine.
Q3: A patient who follows a vegan diet tells the nurse she is worried about getting
"complete protein" without meat. Which food combination should the nurse recommend?
A. Rice and beans [CORRECT]
B. Apple slices with orange juice
C. White bread with strawberry jam
D. Carrot sticks with celery
Correct Answer: A
Rationale: Rice and beans are complementary proteins — together they supply all the
essential amino acids that neither food provides alone. Plant-based diets do not need
animal foods; they just need smart pairings like this one spread across the day.
,Q4: A postoperative patient is eating well and his incision is healing normally. The nurse
recognizes that this patient's nitrogen balance should be:
A. Negative, because tissue is breaking down
B. Unchanged from before surgery
C. In perfect equilibrium
D. Positive, reflecting tissue building and repair [CORRECT]
Correct Answer: D
Rationale: Healing tissue is actively building new protein, so a well-nourished postoperative
patient should show a positive nitrogen balance — intake exceeding output. This matches
the principle of anabolism during recovery.
Q5: A patient with constipation asks the nurse which dietary change will help the most.
Which recommendation is best?
A. Increase soluble fiber and limit water
B. Increase insoluble fiber and drink plenty of fluids [CORRECT]
C. Switch to a clear liquid diet for two weeks
D. Add more simple sugars to the diet
Correct Answer: B
Rationale: Insoluble fiber adds bulk to the stool and stimulates peristalsis, and it needs
adequate fluid to work properly — exactly what a constipated patient requires. Soluble fiber
is gentler and is the better choice for diarrhea or glucose control.
Q6: Which nutrient is the preferred and primary fuel source for the brain?
A. Glucose [CORRECT]
B. Amino acids
C. Fatty acids
D. Fiber
Correct Answer: A
Rationale: Glucose is the fuel the brain runs on, and red blood cells depend on it as well.
Even during fasting, the body works hard to produce enough glucose to keep the brain
supplied.
Q7: While reviewing digestion with a patient, the nurse explains that dietary fat must first
be emulsified before enzymes can break it down. Which substance performs this job?
A. Pepsin
B. Amylase
C. Bile [CORRECT]
D. Insulin
Correct Answer: C
Rationale: Bile, produced by the liver and stored in the gallbladder, emulsifies fat into small
droplets so digestive enzymes can reach it. Without that emulsification, fatty meals are
poorly digested and often cause cramping and loose stools.
Q8: A patient on a very-low-carbohydrate diet tells the nurse that his breath has developed
a fruity odor. What does this finding indicate?
A. Dehydration from fluid restriction
B. Poor dental hygiene
, C. Excess protein storage
D. Ketone production from incomplete fat metabolism [CORRECT]
Correct Answer: D
Rationale: Fruity-smelling breath is a hallmark of ketosis, which develops when
carbohydrate intake is so low that fat is burned incompletely and ketones accumulate. The
body needs a minimum amount of carbohydrate to metabolize fat cleanly.
Q9: Which of the following factors increases a person's basal metabolic rate?
A. Aging
B. Fever [CORRECT]
C. Prolonged calorie restriction
D. A sedentary lifestyle
Correct Answer: B
Rationale: Fever raises the metabolic rate — roughly 7 percent for every degree Fahrenheit
— so calorie and fluid needs climb during illness. Aging, dieting, and inactivity all work in the
opposite direction, lowering metabolic needs.
Q10: A patient's evening snack contains 10 grams of carbohydrate, 5 grams of protein, and 5
grams of fat. How many total kilocalories does this snack provide?
A. 85 kcal
B. 95 kcal
C. 105 kcal [CORRECT]
D. 125 kcal
Correct Answer: C
Rationale: Multiply each gram by its energy value — 10 g carbohydrate times 4, 5 g protein
times 4, and 5 g fat times 9 — which totals 105 kilocalories. This quick math is a handy skill
when teaching patients to read labels.
Q11: A patient with elevated LDL cholesterol asks the nurse which fat he should use for
cooking. Which is the best choice?
A. Olive oil [CORRECT]
B. Butter
C. Stick margarine
D. Coconut oil
Correct Answer: A
Rationale: Olive oil is rich in monounsaturated fat, which helps lower LDL cholesterol when
it replaces saturated fat in the diet. Butter, stick margarine, and coconut oil are all high in
saturated or trans fats.
Q12: A patient with prediabetes asks why whole-grain bread is a better choice than white
bread. Which explanation by the nurse is best?
A. Whole-grain bread has fewer total calories
B. It tastes better than white bread
C. It contains more sodium than white bread
D. Its fiber slows digestion and produces a gradual rise in blood glucose [CORRECT]
Correct Answer: D
