Nutrition NCLEX Questions

Welcome future nurses! To prepare for the NCLEX NextGen, get started here with Free NCLEX Practice Questions with rationales on nutrition. Your source for medical-surgical nursing questions.

Question 1

A nurse is educating a patient with diabetes mellitus type 2 on dietary management. Which of the following food choices by the patient indicates an understanding of the teaching? A. A large banana smoothie made with whole milk B. A bowl of cereal with skim milk C. Grilled salmon with a side of quinoa and vegetables D. A plate of pasta with Alfredo sauce E. Fried chicken with mashed potatoes

Correct Answer: C. Grilled salmon with a side of quinoa and vegetables

Rationale: Grilled salmon with a side of quinoa and vegetables is a balanced meal that provides high-quality protein, complex carbohydrates, and essential fatty acids without excessive saturated fats or simple sugars. This choice supports the dietary goals for diabetes management, which include stabilizing blood sugar levels, promoting heart health, and managing weight. Unlike the other options, this meal is low in unhealthy fats and refined carbohydrates, both of which can exacerbate diabetes symptoms and complications.

Question 2

A nurse is counseling a patient with hypertension on dietary changes to manage their condition. Which of the following dietary modifications should the nurse recommend? A. Increasing intake of red meats B. Adding more salt to food for flavor C. Consuming more canned and processed foods D. Eating whole grains, fruits, and vegetables E. Drinking two glasses of whole milk daily

Correct Answer: D. Eating whole grains, fruits, and vegetables

Rationale: Whole grains, fruits, and vegetables are rich in fiber, vitamins, and minerals that can help lower blood pressure by improving heart health and promoting weight management. These foods are also low in sodium, which is essential for patients with hypertension, as high sodium intake can increase blood pressure. Contrarily, the other options are high in saturated fats, sodium, and added sugars, which can worsen hypertension.

Question 3

A nurse is planning a menu for a patient with chronic kidney disease (CKD). Which of the following food options should the nurse include to manage the patient’s phosphorus levels? A. Cheese omelet B. Lentil soup C. White bread sandwich with turkey D. Nuts and seeds snack pack E. Chocolate milkshake

Correct Answer: C. White bread sandwich with turkey

Rationale: Patients with chronic kidney disease need to manage their phosphorus intake, as their kidneys cannot eliminate excess phosphorus effectively. White bread and turkey are lower in phosphorus compared to cheese, lentils, nuts, seeds, and chocolate products. This meal choice helps in controlling phosphorus levels within a safe range, which is crucial to prevent bone disease and cardiovascular issues associated with high phosphorus levels in CKD.

Question 4

A nurse is providing dietary counseling to a patient recovering from anemia. Which of the following food items should the nurse recommend to increase iron absorption? A. Tea with meals B. Whole grain bread C. Spinach salad with lemon dressing D. Dairy-based desserts E. Egg white omelet

Correct Answer: C. Spinach salad with lemon dressing

Rationale: Spinach is high in iron, which is essential for anemia recovery. The vitamin C in lemon dressing enhances iron absorption from the spinach. Unlike the other options, which either contain substances that inhibit iron absorption (such as the tannins in tea) or are low in iron, this meal directly supports the increase of iron levels in the body, crucial for patients recovering from anemia.

Question 5

A nurse is advising a patient on how to reduce LDL cholesterol levels through diet. Which of the following meal choices is the most appropriate for this patient? A. Buttered popcorn and soda B. Bacon and eggs with toast C. Avocado toast on whole grain bread D. Creamy chicken alfredo pasta E. Cheeseburger with fries

Correct Answer: C. Avocado toast on whole grain bread

Rationale: Avocado is a good source of monounsaturated fats, which can help reduce LDL (bad) cholesterol levels and increase HDL (good) cholesterol levels. Whole grain bread adds dietary fiber, which also aids in lowering cholesterol. This meal choice is heart-healthy, contrasting with the other options that are high in saturated fats and simple carbohydrates, known to increase LDL cholesterol levels and contribute to heart disease.

Question 6

A nurse is discussing weight management with a patient who has recently been diagnosed with obesity. Which of the following snacks would the nurse recommend as part of a weight loss plan? A. A bag of low-fat potato chips B. A chocolate bar C. A piece of fruit with a handful of nuts D. A slice of pepperoni pizza E. A cup of flavored yogurt

Correct Answer: C. A piece of fruit with a handful of nuts

Rationale: A piece of fruit with a handful of nuts is an excellent snack choice for weight management. Fruits provide dietary fiber, which promotes satiety and helps control hunger, while nuts offer healthy fats and protein that also contribute to feeling full longer. This combination can help prevent overeating by providing essential nutrients and energy without excessive calories. The other options are higher in sugars, saturated fats, or calories, which may hinder weight loss efforts.

Question 7

A patient with celiac disease is consulting with a nurse about safe food choices. Which of the following foods is safe for the patient to consume? A. Whole wheat bread B. Barley soup C. Gluten-free oatmeal D. Beer E. Rye crackers

Correct Answer: C. Gluten-free oatmeal

Rationale: Gluten-free oatmeal is safe for individuals with celiac disease because it does not contain gluten, a protein found in wheat, barley, and rye that can damage the intestine in these patients. Ensuring that the oatmeal is labeled gluten-free is important to avoid cross-contamination with gluten-containing grains. The other options contain gluten and can trigger adverse reactions in people with celiac disease.

Question 8

A nurse is planning a heart-healthy diet for a patient with coronary artery disease. Which of the following dinner options should the nurse recommend? A. Fried chicken with french fries B. Cheese lasagna C. Baked salmon with steamed broccoli and brown rice D. Pepperoni pizza E. Cream-based soup with white bread

Correct Answer: C. Baked salmon with steamed broccoli and brown rice

Rationale: Baked salmon with steamed broccoli and brown rice is an ideal heart-healthy dinner option. Salmon is rich in omega-3 fatty acids, which are known to reduce inflammation and lower the risk of heart disease. Steamed broccoli and brown rice add fiber, vitamins, and minerals with minimal saturated fat, supporting cardiovascular health. The other options are high in saturated fats, sodium, and simple carbohydrates, which can worsen coronary artery disease.

Question 9

A nurse is educating a patient with gout on foods to avoid. Which of the following foods should the nurse advise the patient to limit? A. Tofu stir-fry with vegetables B. Low-fat dairy smoothie C. Grilled chicken salad D. Red meat steak E. Whole grain pasta with marinara sauce

Correct Answer: D. Red meat steak

Rationale: Red meat is high in purines, which can increase uric acid levels in the body, leading to gout flare-ups. Patients with gout are advised to limit their intake of high-purine foods to manage their condition and reduce the risk of painful joint inflammation. The other options are lower in purines and are generally considered safer choices for individuals with gout, as they can help maintain a healthy uric acid level.

Question 10

A nurse is providing education on bone health to a postmenopausal woman. Which of the following dietary sources of calcium is the nurse most likely to recommend? A. Cream cheese B. Canned salmon with bones C. Butter D. Ice cream E. Bacon

Correct Answer: B. Canned salmon with bones

Rationale: Canned salmon with bones is an excellent source of calcium, which is essential for bone health, especially in postmenopausal women who are at increased risk for osteoporosis. The bones in canned salmon are soft and edible, providing a high amount of calcium compared to other food items. This choice is particularly beneficial as it also provides omega-3 fatty acids, which can support overall health. The other options contain calcium but in much lower amounts and are higher in saturated fats, making them less ideal for promoting bone health.

Best diet and nutrition guidelines for nursing

This article provides a primer on nutrition for nurses, best diet and nutrition guidelines for nursing with an overview of nutrients to promote health and recovery. Read more below…

The goal of nutrition is to provide sufficient substrates (glucose, protein, lipids, vitamins and minerals) to promote wound healing, maintain the immune system and prevent loss of lean body mass. In trauma victims with burns for example, the caloric and protein needs are estimated according to the percent total body surface area (%TBSA) burn and the patient’s preinjury weight (or ideal body weight if unknown). 

an overview of nutrients to promote health and recovery

There are several approaches to determining a patient’s nutritional status. The first step in a nutrition nurse’s clinical assessment is taking the patient’s medical history. The nurse will ask the individual about their current and past medical conditions, medications, surgeries, and allergies. This information is essential in identifying any medical conditions or drugs affecting the individual’s nutritional status.

How to take a nutrition history

The nurse will also ask the individual about his or her dietary habits, including typical diet, food preferences, and any special dietary needs or restrictions. This information helps identify any dietary factors that may be contributing to the individual’s nutritional status.

Dietary assessment

Dietary assessment involves evaluating an individual’s dietary intake to determine if they meet their nutritional needs. This assessment can be done using various methods, including dietary recalls, food diaries, and food frequency questionnaires. Nutritional assessments are essential in identifying nutrient deficiencies and imbalances in the individual’s diet. They can also help identify dietary patterns that are associated with an increased risk of chronic diseases, such as a high intake of saturated fat and added sugars.

Dietary recalls

Dietary recalls involve asking the individual to recall all the foods and beverages they consumed over a certain period, such as the previous 24 hours or the previous week. This information is then analyzed to determine the individual’s nutrient intake.

Food diaries

Food diaries involve the individual recording all the foods and beverages consumed over a certain period, such as one week. This method provides more detailed information about the individual’s dietary intake than dietary recalls.

Food frequency questionnaire

Food frequency questionnaires involve asking the individual to report how often they consume certain foods and beverages over a certain period, such as the previous month. This method provides an estimate of the individual’s usual dietary intake.

Nutrition-focused physical examination

The next step in a clinical assessment is a physical examination. Clinical assessment involves a physical inspection of the individual to identify any signs and symptoms of malnutrition or other health problems. This assessment will include examining the patient’s body for any signs and symptoms of malnutrition or other health problems. 

The physical examination may include these systems. General appearance: The nurse will assess the individual’s overall appearance and body weight. Skin: The nurse will examine the individual’s skin for any signs of malnutrition, such as dryness or flaking. Hair: The nurse will examine the individual’s hair for signs of malnutrition, such as thinning or dullness. Nails: The nurse will look at the individual’s nails for signs of malnutrition, such as brittleness or ridges. Eyes: The nurse will examine the individual’s eyes for signs of malnutrition, such as dryness or conjunctivitis. Mouth and throat: The nurse will look at the individual’s mouth and throat for any signs and symptoms of malnutrition, such as mouth ulcers or dryness. Gastrointestinal system: The nurse will examine the individual’s abdomen for any signs of malnutrition or gastrointestinal problems. Musculoskeletal system: The nurse will assess the individual’s muscle mass, strength, and density.

Purpose of anthropometric measurements

One way to assess an individual’s nutritional status is by taking anthropometric measurements. Anthropometric measurements are a set of physical measurements. These measurements include height, weight, body mass index (BMI), waist circumference, and skinfold thickness. Anthropometric measurements help identify malnutrition and obesity.

Why is BMI a good measure of health?

Height and weight are used to calculate the BMI. A BMI below 18.5 indicates being underweight, while a BMI above 25 indicates being overweight or obese. Waist circumference is used to determine abdominal obesity, which is a risk factor for cardiovascular disease, type 2 diabetes, and other health problems. Skinfold thickness is used to estimate body fat percentage. This measurement involves using a caliper to measure the thickness of a fold of skin at various locations on the body. The results are then compared to standardized values to determine the individual’s body fat percentage.

Lab tests for nutritional status

Laboratory tests are vital to a clinical assessment because they provide valuable information about the individual’s nutritional status and any underlying health problems. The nutrition nurse may order various laboratory tests.  Complete blood count (CBC): A CBC measures the number and types of blood cells in the body. Abnormalities in the CBC can indicate anemia or other health problems. Comprehensive metabolic panel (CMP): A CMP measures various substances in the blood, including electrolytes, glucose, and liver function tests. Abnormalities in the CMP can indicate liver or kidney problems, diabetes, or other health problems. Lipid panel: A lipid panel measures the levels of various types of fats in the blood, including cholesterol and triglycerides. Abnormalities in the lipid panel can indicate an increased risk of heart disease. Nutrient testing: Nutrient testing measures the levels of specific nutrients in the blood, such as vitamin D or iron. Abnormalities in nutrient testing can indicate nutrient deficiencies or imbalances. Thyroid function tests: Thyroid function tests measure the levels of thyroid hormones in the blood. Abnormalities in thyroid function tests can indicate thyroid problems that may affect the individual’s nutritional status

Biomarkers for nutritional status

Biochemical tests are used to measure the levels of various nutrients and biomarkers in the body. These tests include blood tests, urine tests, and other tests that measure the levels of specific nutrients, such as vitamins, minerals, and macronutrients. For example, a blood test can measure calcium, potassium, and iron levels. Iron is an essential nutrient that is necessary for the formation of red blood cells. A low level of iron can indicate iron deficiency anemia. Other biochemical tests, such as cholesterol and glucose tests, are used to assess the risk of chronic diseases, such as heart disease and diabetes. These tests are important in identifying individuals who are at risk of developing these diseases and can help nutrition nurses provide dietary recommendations to reduce their risk.

Urine test for nutritional deficiencies              

Urine tests are used to measure the levels of certain nutrients and nitrogenous waste products in the urine. For example, a urine test can measure sodium levels, an important electrolyte that helps regulate fluid balance in the body. Abnormal sodium levels in the urine can indicate dehydration or other health problems.

Nutritional screening and assessment tools

Nutrition is an essential aspect of health, and it plays a vital role in preventing and managing diseases. This is particularly important for our patients. Nutrition screening and assessment are critical in identifying patients at risk of malnutrition and determining their nutritional status. Malnutrition can have severe consequences, especially for older patients, leading to impaired immune function, delayed wound healing, and increased risk of infection. Therefore, it is essential to use appropriate screening and assessment tools in hospitalized and outpatients to identify at-risk patients and provide appropriate interventions to prevent and manage malnutrition.One of the most commonly used screening tools for nutritional risk is the Malnutrition Universal Screening Tool (MUST). This tool helps to identify patients at risk of malnutrition. It considers the patient’s Body Mass Index (BMI), unexpected weight loss, and acute or significant chronic disease, which can affect their nutritional status. The MUST categorizes patients into three categories based on their risk of malnutrition and provides recommendations for appropriate interventions depending on the patient’s risk level.Another commonly used nutrition screening tool is the Nutrition Screening Tool (NST), which also uses BMI and weight loss as criteria for nutritional assessment. The NST is more comprehensive than the MUST as it includes factors such as appetite, gastrointestinal symptoms, and recent dietary changes that can affect the patient’s nutritional status. The NST is particularly useful for patients with complex medical conditions and can provide helpful information on their nutritional status.In addition to these screening tools, nutritional assessment tools such as the Mini Nutritional Assessment (MNA) and the Subjective Global Assessment (SGA) can provide a more detailed assessment of the patient’s nutritional status. The MNA is a validated tool that assesses various aspects of nutritional status, dietary intake, mobility, and psychological factors. It is beneficial for older adults who are at risk of malnutrition. On the other hand, the SGA is a clinical tool that uses a combination of subjective and objective data to assess the patient’s nutritional status. It considers factors such as weight loss, body composition changes, and underlying diseases.Nutritional screening should be a routine part of patient assessment in all healthcare settings, including hospitals, long-term care facilities, and primary care settings. Screening should be performed regularly, especially for patients at high risk of malnutrition, such as older adults or those with chronic medical conditions.Several risk factors can contribute to malnutrition, such as inadequate dietary intake, weight loss, chronic diseases, and impaired functional status. Identifying these risk factors is crucial in assessing the patient’s nutritional status and implementing appropriate interventions to prevent and manage malnutrition.Nutritional screening and assessment are essential for identifying patients at risk of malnutrition and providing appropriate interventions. Using validated screening and assessment tools such as the MUST, NST, MNA, and SGA can help nutrition nurses assess the patient’s nutritional status accurately and assess in implementing appropriate interventions early to prevent and treat malnutrition.

Understanding the caloric requirements in hospitalized patients

What are the caloric requirements?

This may overestimate caloric requirements as it does not take into account age and sex.  

Feeding may necessitate the supplementation of insulin PATHOPHYSIOLOGY:  Although insulin is not decreased in burn patients (it is actually increased).  The increased serum cortisol and glucagon are increased resulting in glucose intolerance.  

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