RN HESI NUTRITION EXIT EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026/2027 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Macronutrients and Energy Metabolism
Micronutrients: Vitamins, Minerals, and Electrolytes
Nutritional Assessment and Screening
Therapeutic Diets and Disease Management
Enteral and Parenteral Nutrition
Nutrition Across the Lifespan
Clinical Judgment and NGN Case Studies
Patient Education and Cultural Considerations
Introduction
This comprehensive study guide prepares nursing students for the RN HESI Nutrition Exit
Examination. It assesses knowledge of nutrition fundamentals, macronutrients, micronutrients,
therapeutic diets, and nutrition support, with emphasis on clinical judgment and real-world
application. The test includes multiple-choice and NGN-style scenario-based questions that
mirror the Next Generation NCLEX format, covering nutritional assessment, disease-specific
dietary management, enteral and parenteral nutrition, and patient education. Candidates must
apply critical thinking to prioritize safe, evidence-based nutritional interventions across diverse
populations and healthcare settings.
SECTION ONE: QUESTIONS 1–200
1. A nurse is assessing a patient for signs of protein-energy malnutrition. Which findings
support this diagnosis? (Select all that apply.)
🟢 A. BMI of 17
🟢 B. Presence of temporal wasting
C. Albumin level of 4.5 g/dL
,🟢 D. Poor wound healing
E. Complaints of hunger
🔴 RATIONALE: A BMI of 17 indicates underweight, temporal wasting is a sign of muscle loss,
and poor wound healing is a direct result of protein deficiency. An albumin of 4.5 is normal,
and hunger is not always present in malnutrition.
2. Which laboratory value is most useful for evaluating the acute response to nutritional
intervention in a critically ill patient?
A. Albumin
🟢 B. Prealbumin
C. Transferrin
D. Hemoglobin
🔴 RATIONALE: Prealbumin has a short half-life of 2 to 3 days, making it a sensitive indicator of
short-term nutritional changes. Albumin (half-life 20 days) is a better marker for chronic status.
3. A nurse is reviewing a new TPN order. Which intervention is critical to prevent infection?
A. Changing the central line dressing every 12 hours
🟢 B. Using a dedicated lumen for TPN only
C. Warming the TPN solution in a microwave
D. Adding vitamins immediately to the lipid emulsion
🔴 RATIONALE: A dedicated lumen is crucial to prevent line sepsis or precipitates forming
when incompatible drugs are mixed. TPN is usually prepared by pharmacy and should not be
microwaved. Vitamins should be added to the amino acid solution, not lipids, just before
administration. Dressings are changed every 5-7 days per protocol unless soiled.
4. A patient is receiving continuous tube feeding. The nurse checks the gastric residual
volume (GRV) and obtains 300 mL. The institutional protocol specifies holding the feeding if
the GRV is >250 mL. What is the nurse's first action?
A. Slow the rate of the feeding
🟢 B. Hold the feeding and notify the provider
C. Elevate the head of the bed to 90 degrees
D. Administer a prokinetic agent
,🔴 RATIONALE: The nurse must follow the institutional protocol. Since 300 mL exceeds the
threshold of 250 mL, the feeding must be held to prevent aspiration, and the provider should
be notified for further instructions.
5. A patient with Chronic Kidney Disease (CKD) stage 3 asks for a snack. Which food choice
is most appropriate given their dietary restrictions?
🟢 A. Apple
B. Banana
C. Cheese stick
D. Orange juice
🔴 RATIONALE: Patients with CKD often need to restrict potassium (bananas, oranges) and
phosphorus (dairy/cheese). Apples are lower in potassium and phosphorus, making them a
safer choice.
6. The nurse is teaching a patient with hypertension about the DASH diet. Which food
should the nurse encourage the patient to limit?
A. Fresh carrots
B. Skim milk
🟢 C. Canned soup
D. Brown rice
🔴 RATIONALE: Canned soups are high in sodium and should be limited on the DASH diet,
which emphasizes low-sodium foods to reduce blood pressure.
7. Which nutrient provides the most concentrated source of energy per gram?
A. Carbohydrates
B. Protein
🟢 C. Fat
D. Alcohol
🔴 RATIONALE: Fat provides 9 kcal/g, while carbohydrates and protein provide 4 kcal/g each;
alcohol provides 7 kcal/g.
8. A client on a clear liquid diet can consume which of the following?
, A. Milk
🟢 B. Apple juice
C. Cream soup
D. Ice cream
🔴 RATIONALE: Clear liquids are transparent at room temperature and leave minimal residue;
milk and cream soups are not clear.
9. Which vitamin deficiency causes night blindness?
A. Vitamin C
🟢 B. Vitamin A
C. Vitamin D
D. Vitamin K
🔴 RATIONALE: Vitamin A is essential for rhodopsin formation in the retina; deficiency causes
night blindness and xerophthalmia.
10. A client with hypertension should limit intake of which mineral?
A. Potassium
B. Calcium
🟢 C. Sodium
D. Magnesium
🔴 RATIONALE: Sodium restriction reduces fluid retention and lowers blood pressure; the
DASH diet emphasizes low sodium.
11. Which food is the best source of vitamin C?
A. Milk
🟢 B. Orange
C. Bread
D. Chicken
🔴 RATIONALE: Citrus fruits are rich in vitamin C; milk and meats lack significant vitamin C.
12. A client with chronic kidney disease should limit which nutrient?
ANSWERS) PLUS RATIONALES 2026/2027 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Macronutrients and Energy Metabolism
Micronutrients: Vitamins, Minerals, and Electrolytes
Nutritional Assessment and Screening
Therapeutic Diets and Disease Management
Enteral and Parenteral Nutrition
Nutrition Across the Lifespan
Clinical Judgment and NGN Case Studies
Patient Education and Cultural Considerations
Introduction
This comprehensive study guide prepares nursing students for the RN HESI Nutrition Exit
Examination. It assesses knowledge of nutrition fundamentals, macronutrients, micronutrients,
therapeutic diets, and nutrition support, with emphasis on clinical judgment and real-world
application. The test includes multiple-choice and NGN-style scenario-based questions that
mirror the Next Generation NCLEX format, covering nutritional assessment, disease-specific
dietary management, enteral and parenteral nutrition, and patient education. Candidates must
apply critical thinking to prioritize safe, evidence-based nutritional interventions across diverse
populations and healthcare settings.
SECTION ONE: QUESTIONS 1–200
1. A nurse is assessing a patient for signs of protein-energy malnutrition. Which findings
support this diagnosis? (Select all that apply.)
🟢 A. BMI of 17
🟢 B. Presence of temporal wasting
C. Albumin level of 4.5 g/dL
,🟢 D. Poor wound healing
E. Complaints of hunger
🔴 RATIONALE: A BMI of 17 indicates underweight, temporal wasting is a sign of muscle loss,
and poor wound healing is a direct result of protein deficiency. An albumin of 4.5 is normal,
and hunger is not always present in malnutrition.
2. Which laboratory value is most useful for evaluating the acute response to nutritional
intervention in a critically ill patient?
A. Albumin
🟢 B. Prealbumin
C. Transferrin
D. Hemoglobin
🔴 RATIONALE: Prealbumin has a short half-life of 2 to 3 days, making it a sensitive indicator of
short-term nutritional changes. Albumin (half-life 20 days) is a better marker for chronic status.
3. A nurse is reviewing a new TPN order. Which intervention is critical to prevent infection?
A. Changing the central line dressing every 12 hours
🟢 B. Using a dedicated lumen for TPN only
C. Warming the TPN solution in a microwave
D. Adding vitamins immediately to the lipid emulsion
🔴 RATIONALE: A dedicated lumen is crucial to prevent line sepsis or precipitates forming
when incompatible drugs are mixed. TPN is usually prepared by pharmacy and should not be
microwaved. Vitamins should be added to the amino acid solution, not lipids, just before
administration. Dressings are changed every 5-7 days per protocol unless soiled.
4. A patient is receiving continuous tube feeding. The nurse checks the gastric residual
volume (GRV) and obtains 300 mL. The institutional protocol specifies holding the feeding if
the GRV is >250 mL. What is the nurse's first action?
A. Slow the rate of the feeding
🟢 B. Hold the feeding and notify the provider
C. Elevate the head of the bed to 90 degrees
D. Administer a prokinetic agent
,🔴 RATIONALE: The nurse must follow the institutional protocol. Since 300 mL exceeds the
threshold of 250 mL, the feeding must be held to prevent aspiration, and the provider should
be notified for further instructions.
5. A patient with Chronic Kidney Disease (CKD) stage 3 asks for a snack. Which food choice
is most appropriate given their dietary restrictions?
🟢 A. Apple
B. Banana
C. Cheese stick
D. Orange juice
🔴 RATIONALE: Patients with CKD often need to restrict potassium (bananas, oranges) and
phosphorus (dairy/cheese). Apples are lower in potassium and phosphorus, making them a
safer choice.
6. The nurse is teaching a patient with hypertension about the DASH diet. Which food
should the nurse encourage the patient to limit?
A. Fresh carrots
B. Skim milk
🟢 C. Canned soup
D. Brown rice
🔴 RATIONALE: Canned soups are high in sodium and should be limited on the DASH diet,
which emphasizes low-sodium foods to reduce blood pressure.
7. Which nutrient provides the most concentrated source of energy per gram?
A. Carbohydrates
B. Protein
🟢 C. Fat
D. Alcohol
🔴 RATIONALE: Fat provides 9 kcal/g, while carbohydrates and protein provide 4 kcal/g each;
alcohol provides 7 kcal/g.
8. A client on a clear liquid diet can consume which of the following?
, A. Milk
🟢 B. Apple juice
C. Cream soup
D. Ice cream
🔴 RATIONALE: Clear liquids are transparent at room temperature and leave minimal residue;
milk and cream soups are not clear.
9. Which vitamin deficiency causes night blindness?
A. Vitamin C
🟢 B. Vitamin A
C. Vitamin D
D. Vitamin K
🔴 RATIONALE: Vitamin A is essential for rhodopsin formation in the retina; deficiency causes
night blindness and xerophthalmia.
10. A client with hypertension should limit intake of which mineral?
A. Potassium
B. Calcium
🟢 C. Sodium
D. Magnesium
🔴 RATIONALE: Sodium restriction reduces fluid retention and lowers blood pressure; the
DASH diet emphasizes low sodium.
11. Which food is the best source of vitamin C?
A. Milk
🟢 B. Orange
C. Bread
D. Chicken
🔴 RATIONALE: Citrus fruits are rich in vitamin C; milk and meats lack significant vitamin C.
12. A client with chronic kidney disease should limit which nutrient?
