Nursing Nutrition – Nursing Program – 2026 – Questions and correct
answers
NURSING NUTRITION EXAM 1
Comprehensive 60-Question Practice Examination
SECTION 1: PRINCIPLES OF NUTRITION & HEALTH (Questions 1-20)
Question 1: A nurse is reviewing laboratory results for a 45-year-old male patient with a BMI of 32 who
reports following a very low-carbohydrate diet for weight loss. Which finding requires immediate follow-
up?
A) Total cholesterol of 180 mg/dL B) Triglycerides of 250 mg/dL C) Ketones 2+ in urine with blood pH
7.28 D) Fasting blood glucose of 95 mg/dL
Correct Answer: C
Explainer: The presence of ketones in urine combined with an acidotic blood pH (normal 7.35-7.45)
indicates metabolic acidosis, likely from excessive ketone production due to inadequate carbohydrate
intake. While ketosis is expected on low-carb diets, significant acidosis can lead to electrolyte
imbalances, altered mental status, and cardiac arrhythmias. This requires immediate intervention to
prevent progression to diabetic ketoacidosis-like states or severe metabolic compromise. The other
values, while the triglycerides are elevated, do not represent immediate threats to physiological
stability.
Question 2: A patient with chronic kidney disease stage 4 is receiving dietary teaching about protein
intake. Which statement by the patient demonstrates correct understanding of the recommended
protein modification?
A) "I should increase my protein intake to help maintain my muscle mass." B) "I need to limit protein to
reduce the buildup of nitrogenous waste products." C) "Plant proteins are restricted more than animal
proteins in my condition." D) "Protein restrictions only apply if I am not receiving dialysis."
Correct Answer: B
Explainer: In chronic kidney disease stage 4, protein restriction (typically 0.6-0.8 g/kg/day) is
recommended to reduce the glomerular filtration workload and minimize accumulation of urea,
creatinine, and other nitrogenous waste products that the compromised kidneys cannot adequately
excrete. This helps delay progression to end-stage renal disease and reduces uremic symptoms. While
dialysis patients require increased protein, pre-dialysis CKD patients benefit from restriction. Plant
proteins are often encouraged over animal proteins due to lower phosphorus bioavailability and
reduced acid load.
,Question 3: A nurse is caring for a patient with fat malabsorption secondary to Crohn's disease. Which
vitamin deficiency should the nurse anticipate and monitor for most closely?
A) Vitamin C B) Vitamin B12 C) Folic acid D) Vitamin K
Correct Answer: D
Explainer: Vitamins A, D, E, and K are fat-soluble vitamins requiring adequate fat absorption and micelle
formation for intestinal uptake. Vitamin K deficiency is particularly concerning in Crohn's disease with fat
malabsorption because it can lead to coagulopathy and bleeding risk. The terminal ileum involvement
common in Crohn's also affects bile acid reabsorption, further impairing fat digestion. While B12 (option
B) is also commonly deficient in Crohn's due to terminal ileum involvement, this is due to intrinsic factor-
B12 complex absorption issues rather than fat malabsorption specifically.
Question 4: A 28-year-old female athlete presents with fatigue, hair loss, and amenorrhea. Her diet
consists primarily of vegetables, fruits, and whole grains with minimal animal products. Which
nutritional deficiency is most likely contributing to her clinical presentation?
A) Vitamin B12 B) Iron C) Zinc D) All of the above
Correct Answer: D
Explainer: This patient exhibits classic signs of multiple deficiencies common in restrictive plant-based
diets without proper supplementation. Iron deficiency causes fatigue and hair loss; heme iron from
animal sources has 15-35% bioavailability compared to 2-20% for non-heme plant iron. Zinc deficiency
contributes to hair loss, impaired immunity, and hormonal disruptions affecting menstruation. Vitamin
B12 deficiency causes fatigue, neurological symptoms, and can affect reproductive hormones. The
combination of amenorrhea, fatigue, and hair loss in an athlete with limited animal product intake
strongly suggests a multifactorial nutritional deficiency requiring comprehensive assessment and
targeted supplementation.
Question 5: A patient with heart failure is prescribed a 2-gram sodium diet. Which meal selection by the
patient indicates the need for immediate dietary reinforcement?
A) Grilled chicken breast with steamed broccoli and rice B) Turkey sandwich with one slice of cheese and
mustard C) Canned chicken noodle soup with saltine crackers D) Fresh salad with oil and vinegar
dressing
Correct Answer: C
Explainer: Canned soups are notoriously high in sodium, with a single serving often containing 600-900
mg or more. Combined with saltine crackers (approximately 150-200 mg sodium per serving), this meal
alone could exceed half or more of the patient's daily sodium allowance. Heart failure patients require
strict sodium restriction to prevent fluid retention, which exacerbates symptoms of dyspnea, peripheral
, edema, and increases cardiac workload. The high sodium content in processed and canned foods
represents one of the most common dietary challenges for heart failure management.
Question 6: A nurse is teaching a patient about glycemic index (GI) and glycemic load (GL). Which
statement by the patient indicates correct understanding of these concepts?
A) "A baked potato has a lower glycemic index than table sugar, so it's better for my blood sugar." B)
"The glycemic load considers both the quality and quantity of carbohydrates consumed." C) "Foods with
high glycemic index should always be avoided by people with diabetes." D) "Protein and fat content do
not affect how quickly carbohydrates raise blood sugar."
Correct Answer: B
Explainer: Glycemic load (GL) is calculated by multiplying the glycemic index (quality of carbohydrate) by
the amount of carbohydrate in a serving (quantity), then dividing by 100. This provides a more practical
measure of a food's real-world impact on blood glucose. For example, watermelon has a high GI (72) but
low GL (4) due to high water content and typical serving size. Understanding GL helps patients make
informed choices about portion sizes and meal composition rather than simply avoiding all high-GI
foods, which is neither practical nor necessary with proper meal planning.
Question 7: A patient with celiac disease asks the nurse about hidden sources of gluten. Which product
should the nurse identify as a potential hidden source requiring caution?
A) Plain rice B) Distilled vinegar C) Malt flavoring in cereal D) Fresh corn tortillas
Correct Answer: C
Explainer: Malt and malt flavoring are derived from barley, which contains gluten and must be strictly
avoided in celiac disease. Barley malt is commonly used as a sweetener in cereals, beverages, and
processed foods. While distilled vinegar (option B) is safe due to the distillation process removing gluten
proteins, malt vinegar is not distilled and contains gluten. Plain rice and corn are naturally gluten-free
grains. Nurses must educate celiac patients about reading labels for malt, malt extract, malt syrup, and
malt flavoring as these indicate barley-derived ingredients that trigger autoimmune responses in celiac
disease.
Question 8: A nurse is calculating the protein needs for a patient with severe burns covering 40% of
total body surface area. Which factor should the nurse consider when determining protein
requirements?
A) Protein needs decrease during the acute inflammatory phase to conserve energy B) Requirements
increase to 1.5-2.0 g/kg/day to support wound healing and immune function C) Standard protein
requirements of 0.8 g/kg/day are sufficient with adequate calories D) Protein should be restricted to
prevent stress on the kidneys during fluid resuscitation
Correct Answer: B
answers
NURSING NUTRITION EXAM 1
Comprehensive 60-Question Practice Examination
SECTION 1: PRINCIPLES OF NUTRITION & HEALTH (Questions 1-20)
Question 1: A nurse is reviewing laboratory results for a 45-year-old male patient with a BMI of 32 who
reports following a very low-carbohydrate diet for weight loss. Which finding requires immediate follow-
up?
A) Total cholesterol of 180 mg/dL B) Triglycerides of 250 mg/dL C) Ketones 2+ in urine with blood pH
7.28 D) Fasting blood glucose of 95 mg/dL
Correct Answer: C
Explainer: The presence of ketones in urine combined with an acidotic blood pH (normal 7.35-7.45)
indicates metabolic acidosis, likely from excessive ketone production due to inadequate carbohydrate
intake. While ketosis is expected on low-carb diets, significant acidosis can lead to electrolyte
imbalances, altered mental status, and cardiac arrhythmias. This requires immediate intervention to
prevent progression to diabetic ketoacidosis-like states or severe metabolic compromise. The other
values, while the triglycerides are elevated, do not represent immediate threats to physiological
stability.
Question 2: A patient with chronic kidney disease stage 4 is receiving dietary teaching about protein
intake. Which statement by the patient demonstrates correct understanding of the recommended
protein modification?
A) "I should increase my protein intake to help maintain my muscle mass." B) "I need to limit protein to
reduce the buildup of nitrogenous waste products." C) "Plant proteins are restricted more than animal
proteins in my condition." D) "Protein restrictions only apply if I am not receiving dialysis."
Correct Answer: B
Explainer: In chronic kidney disease stage 4, protein restriction (typically 0.6-0.8 g/kg/day) is
recommended to reduce the glomerular filtration workload and minimize accumulation of urea,
creatinine, and other nitrogenous waste products that the compromised kidneys cannot adequately
excrete. This helps delay progression to end-stage renal disease and reduces uremic symptoms. While
dialysis patients require increased protein, pre-dialysis CKD patients benefit from restriction. Plant
proteins are often encouraged over animal proteins due to lower phosphorus bioavailability and
reduced acid load.
,Question 3: A nurse is caring for a patient with fat malabsorption secondary to Crohn's disease. Which
vitamin deficiency should the nurse anticipate and monitor for most closely?
A) Vitamin C B) Vitamin B12 C) Folic acid D) Vitamin K
Correct Answer: D
Explainer: Vitamins A, D, E, and K are fat-soluble vitamins requiring adequate fat absorption and micelle
formation for intestinal uptake. Vitamin K deficiency is particularly concerning in Crohn's disease with fat
malabsorption because it can lead to coagulopathy and bleeding risk. The terminal ileum involvement
common in Crohn's also affects bile acid reabsorption, further impairing fat digestion. While B12 (option
B) is also commonly deficient in Crohn's due to terminal ileum involvement, this is due to intrinsic factor-
B12 complex absorption issues rather than fat malabsorption specifically.
Question 4: A 28-year-old female athlete presents with fatigue, hair loss, and amenorrhea. Her diet
consists primarily of vegetables, fruits, and whole grains with minimal animal products. Which
nutritional deficiency is most likely contributing to her clinical presentation?
A) Vitamin B12 B) Iron C) Zinc D) All of the above
Correct Answer: D
Explainer: This patient exhibits classic signs of multiple deficiencies common in restrictive plant-based
diets without proper supplementation. Iron deficiency causes fatigue and hair loss; heme iron from
animal sources has 15-35% bioavailability compared to 2-20% for non-heme plant iron. Zinc deficiency
contributes to hair loss, impaired immunity, and hormonal disruptions affecting menstruation. Vitamin
B12 deficiency causes fatigue, neurological symptoms, and can affect reproductive hormones. The
combination of amenorrhea, fatigue, and hair loss in an athlete with limited animal product intake
strongly suggests a multifactorial nutritional deficiency requiring comprehensive assessment and
targeted supplementation.
Question 5: A patient with heart failure is prescribed a 2-gram sodium diet. Which meal selection by the
patient indicates the need for immediate dietary reinforcement?
A) Grilled chicken breast with steamed broccoli and rice B) Turkey sandwich with one slice of cheese and
mustard C) Canned chicken noodle soup with saltine crackers D) Fresh salad with oil and vinegar
dressing
Correct Answer: C
Explainer: Canned soups are notoriously high in sodium, with a single serving often containing 600-900
mg or more. Combined with saltine crackers (approximately 150-200 mg sodium per serving), this meal
alone could exceed half or more of the patient's daily sodium allowance. Heart failure patients require
strict sodium restriction to prevent fluid retention, which exacerbates symptoms of dyspnea, peripheral
, edema, and increases cardiac workload. The high sodium content in processed and canned foods
represents one of the most common dietary challenges for heart failure management.
Question 6: A nurse is teaching a patient about glycemic index (GI) and glycemic load (GL). Which
statement by the patient indicates correct understanding of these concepts?
A) "A baked potato has a lower glycemic index than table sugar, so it's better for my blood sugar." B)
"The glycemic load considers both the quality and quantity of carbohydrates consumed." C) "Foods with
high glycemic index should always be avoided by people with diabetes." D) "Protein and fat content do
not affect how quickly carbohydrates raise blood sugar."
Correct Answer: B
Explainer: Glycemic load (GL) is calculated by multiplying the glycemic index (quality of carbohydrate) by
the amount of carbohydrate in a serving (quantity), then dividing by 100. This provides a more practical
measure of a food's real-world impact on blood glucose. For example, watermelon has a high GI (72) but
low GL (4) due to high water content and typical serving size. Understanding GL helps patients make
informed choices about portion sizes and meal composition rather than simply avoiding all high-GI
foods, which is neither practical nor necessary with proper meal planning.
Question 7: A patient with celiac disease asks the nurse about hidden sources of gluten. Which product
should the nurse identify as a potential hidden source requiring caution?
A) Plain rice B) Distilled vinegar C) Malt flavoring in cereal D) Fresh corn tortillas
Correct Answer: C
Explainer: Malt and malt flavoring are derived from barley, which contains gluten and must be strictly
avoided in celiac disease. Barley malt is commonly used as a sweetener in cereals, beverages, and
processed foods. While distilled vinegar (option B) is safe due to the distillation process removing gluten
proteins, malt vinegar is not distilled and contains gluten. Plain rice and corn are naturally gluten-free
grains. Nurses must educate celiac patients about reading labels for malt, malt extract, malt syrup, and
malt flavoring as these indicate barley-derived ingredients that trigger autoimmune responses in celiac
disease.
Question 8: A nurse is calculating the protein needs for a patient with severe burns covering 40% of
total body surface area. Which factor should the nurse consider when determining protein
requirements?
A) Protein needs decrease during the acute inflammatory phase to conserve energy B) Requirements
increase to 1.5-2.0 g/kg/day to support wound healing and immune function C) Standard protein
requirements of 0.8 g/kg/day are sufficient with adequate calories D) Protein should be restricted to
prevent stress on the kidneys during fluid resuscitation
Correct Answer: B
