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CORE DOMAINS
*Nutrient Metabolism and Energy Balance*
*Therapeutic Diets and Clinical Nutrition*
*Lifespan Nutritional Requirements*
*Food Safety and Sanitation Standards*
*Nutrition-Related Pharmacotherapy*
*Assessment and Laboratory Data Interpretation*
*Enteral and Parenteral Nutrition Support*
*Cultural and Religious Dietary Considerations*
INTRODUCTION
*This assessment is designed to evaluate comprehensive knowledge of clinical
nutrition in professional nursing practice. It measures the ability to integrate nutritional
science into patient care, ranging from foundational metabolic theory to complex
therapeutic interventions. The exam utilizes a series of multiple-choice and scenario-based
questions that mirror real-world clinical environments. Candidates are tested on their
decision-making skills, clinical judgment regarding dietary modifications, and understanding
of regulatory standards in nutritional therapy. Success on this assessment requires a rigorous
application of evidence-based practice to ensure optimal patient outcomes through targeted
nutritional interventions and multidisciplinary collaboration.*
SECTION ONE: QUESTIONS 1–100
1. A nurse is providing education to a client with iron-deficiency anemia regarding food
choices. Which of the following selections indicates the client understands the
teaching? A. Spinach and orange juice B. Milk and whole grain bread C. Yogurt and
berries D. Cheese and crackers A. Spinach and orange juice Explanation:
Vitamin C, found in orange juice, significantly enhances the absorption of non-heme
iron from plant sources like spinach.
2. A client is prescribed warfarin. Which of the following foods should the nurse instruct
the client to consume in consistent amounts? A. Spinach B. Apples C. Pasta D.
Chicken A. Spinach Explanation: Spinach is high in vitamin K, which
, antagonizes the effects of warfarin. Consistent intake is necessary to maintain stable
therapeutic levels.
3. Which of the following findings in a client’s lab report indicates a state of
malnutrition? A. Elevated hemoglobin B. Decreased serum albumin C. Elevated
lymphocyte count D. Increased transferrin B. Decreased serum albumin
Explanation: Serum albumin is a common marker for nutritional status; low levels are
frequently associated with protein-calorie malnutrition and inflammation.
4. A nurse is caring for a client who has a new prescription for enteral feedings. Which
of the following actions is the priority? A. Flush the tube with 30 mL of water B.
Verify the placement of the feeding tube C. Check the gastric residual volume D.
Raise the head of the bed to 45 degrees B. Verify the placement of the feeding
tube Explanation: The most critical step before initiating any enteral feeding is
ensuring the tube is correctly placed in the stomach or small intestine to prevent
aspiration pneumonia.
5. A client who is pregnant asks about increasing folic acid intake. Which of the
following foods is the best source? A. Lentils B. Corn C. Potatoes D. Apples A.
Lentils Explanation: Legumes, such as lentils, are an excellent source of dietary
folate, which is essential for preventing neural tube defects in the fetus.
6. A nurse is discussing low-sodium diets with a client who has hypertension. Which of
the following foods should the client avoid? A. Fresh berries B. Canned soups C.
Grilled chicken D. Brown rice B. Canned soups Explanation: Canned soups are
typically processed with high levels of sodium for preservation, which contradicts the
goal of a low-sodium diet for hypertension management.
7. Which of the following types of vegetarian diets includes dairy products but excludes
eggs and meat? A. Vegan B. Lacto-vegetarian C. Ovo-vegetarian D. Lacto-ovo-
vegetarian B. Lacto-vegetarian Explanation: A lacto-vegetarian diet includes
dairy products but excludes meat, poultry, fish, and eggs.
8. A client has a pressure ulcer and requires a diet to promote wound healing. Which of
the following nutrients should the nurse prioritize? A. Carbohydrates B. Protein C. Fat
D. Fiber B. Protein Explanation: Protein is essential for tissue repair and
collagen synthesis, which are critical for the healing of pressure ulcers.
9. A nurse is teaching a client about vitamin B12 deficiency. Which of the following food
groups should the nurse recommend? A. Citrus fruits B. Green leafy vegetables C.
Animal products D. Whole grains C. Animal products Explanation: Vitamin
B12 is found naturally only in animal-based foods; therefore, vegetarians are at high
risk for deficiency without supplementation or fortified foods.
, 10. Which of the following represents a reliable method for assessing a client’s
nutritional intake over the past 24 hours? A. Food frequency questionnaire B. 24-
hour dietary recall C. Calorie count D. Food diary B. 24-hour dietary recall
Explanation: A 24-hour dietary recall provides a snapshot of actual recent intake,
helping the nurse identify current eating patterns and potential deficiencies.
11. A nurse is caring for a client with dumping syndrome. Which of the following dietary
modifications should be recommended? A. Consume high-fiber meals B. Drink fluids
with meals C. Lie down after eating D. Eat three large meals per day C. Lie down
after eating Explanation: Lying down after meals slows gastric emptying and
helps alleviate the symptoms of dumping syndrome by reducing the rate at which
food enters the small intestine.
12. A nurse is planning care for a client who is following a kosher diet. Which of the
following menu selections is appropriate? A. Shrimp cocktail B. Roast beef and
cheese C. Salmon D. Pork chops C. Salmon Explanation: According to kosher
laws, fish with fins and scales (like salmon) are permitted, while shellfish and the
mixing of meat and dairy are prohibited.
13. Which of the following is the primary role of carbohydrates in the body? A. Tissue
repair B. Energy production C. Enzyme synthesis D. Immune regulation B. Energy
production Explanation: Carbohydrates are the body's primary and most efficient
source of energy, specifically for the brain and central nervous system.
14. A client is receiving parenteral nutrition. Which of the following actions should the
nurse take to prevent a catheter-related infection? A. Change the IV tubing every 72
hours B. Use strict aseptic technique during site care C. Administer the infusion at a
rapid rate D. Discontinue the infusion every 4 hours B. Use strict aseptic
technique during site care Explanation: Strict aseptic technique is the most
important measure in preventing bloodstream infections related to central venous
catheters used for parenteral nutrition.
15. A nurse is teaching a client about the DASH diet. Which of the following goals is the
primary focus? A. Weight loss through ketosis B. Reducing blood pressure C.
Improving glycemic control D. Increasing protein intake B. Reducing blood
pressure Explanation: The DASH (Dietary Approaches to Stop Hypertension) diet
is specifically formulated to lower blood pressure by emphasizing fruits, vegetables,
and low-fat dairy.
16. Which of the following clinical findings indicates a client may be dehydrated? A.
Increased blood pressure B. Elevated heart rate C. Decreased urine specific gravity D.
Moist mucous membranes B. Elevated heart rate Explanation: Tachycardia is