NR 228 Exam 3: Nutrition, Health & Wellness -
Chamberlain University Updated and Latest Questions and
Correct Answers with Rationale
1. A client with type 1 diabetes mellitus is being taught how to manage their diet during illness. Which
instruction should the nurse include regarding carbohydrate intake?
A. Discontinue all carbohydrate intake until the fever subsides.
B. Increase carbohydrate intake by 50% to compensate for increased metabolic demand.
C. Substitute regular carbohydrate choices with liquid sources if solids are not tolerated.
D. Consume only high-protein liquids to prevent muscle wasting during illness.
Correct Answer: C
Rationale: During illness, it is vital for patients with type 1 diabetes to continue consuming
carbohydrates to prevent hypoglycemia and ketoacidosis. If solid foods are not tolerated, the client
should use liquid or semi-liquid sources like juice or gelatin to meet their needs. Standard protocol
suggests 10 to 15 grams of carbohydrates every 1 to 2 hours while awake. Monitoring blood glucose
frequently is also necessary to adjust insulin doses as metabolic stress increases requirements. This
approach ensures the body has enough glucose to prevent the breakdown of fats for energy.
2. The nurse is reviewing the laboratory results for a client with chronic kidney disease and hypertension.
Which dietary mineral restriction is most critical to prevent further fluid retention and cardiovascular
strain?
A. Sodium
B. Calcium
C. Magnesium
,D. Zinc
Correct Answer: A
Rationale: Sodium restriction is essential in managing chronic kidney disease and hypertension because
sodium causes water retention. Excessive fluid volume increases the workload on the heart and raises
blood pressure levels significantly. Most therapeutic diets for these conditions limit sodium to less than
2,300 milligrams per day. Reducing sodium helps mitigate edema and prevents the progression of
congestive heart failure. Clients are encouraged to avoid processed foods and use herbs for seasoning
instead of table salt.
3. Which dietary modification is most appropriate for a patient diagnosed with Celiac disease to prevent
malabsorption and intestinal damage?
A. Eliminate all dairy products containing lactose.
B. Increase intake of soluble fiber to slow digestion.
C. Avoid products containing wheat, barley, and rye.
D. Follow a low-FODMAP diet to reduce gas and bloating.
Correct Answer: C
Rationale: Celiac disease is an autoimmune disorder triggered by the ingestion of gluten found in specific
grains. Ingesting wheat, barley, or rye causes an inflammatory response that damages the villi of the
small intestine. This damage leads to severe malabsorption of nutrients and various gastrointestinal
symptoms. Strict adherence to a gluten-free diet is the only effective treatment to allow the intestinal
mucosa to heal. Patients must be educated on reading labels carefully to identify hidden sources of gluten
in processed items.
,4. A client with Dumping Syndrome following a gastric bypass surgery should be instructed to follow which
nutritional guideline?
A. Eat small, frequent meals and avoid liquids during mealtime.
B. Consume high-sugar liquids to maintain energy levels.
C. Drink at least 12 ounces of water with every meal.
D. Lie down for 30 minutes before eating to slow motility.
Correct Answer: A
Rationale: Dumping syndrome occurs when food moves too rapidly from the stomach into the small
intestine. Consuming liquids with meals speeds up this process and should be avoided by waiting 30 to
60 minutes after eating. Small, frequent meals help manage the volume of food and reduce the osmotic
load in the duodenum. Patients should also avoid high-sugar foods which contribute to the rapid shift of
fluid into the gut. Lying down after meals, rather than before, can help slow the movement of food
through the digestive tract.
5. Which food should a nurse recommend to a client on a DASH (Dietary Approaches to Stop Hypertension)
diet to increase potassium intake?
A. Canned vegetable soup
B. Fresh bananas and spinach
C. White bread and pasta
D. Processed deli meats
Correct Answer: B
Rationale: The DASH diet emphasizes high intake of potassium, calcium, and magnesium to help lower
blood pressure. Fresh fruits like bananas and leafy greens like spinach are excellent sources of naturally
, occurring potassium. High potassium intake helps the kidneys excrete sodium and eases tension in the
blood vessel walls. In contrast, canned soups and deli meats are typically very high in sodium and should
be avoided. Following these guidelines helps reduce the risk of stroke and other cardiovascular
complications.
6. A client with Congestive Heart Failure (CHF) is prescribed a 2-gram sodium diet. Which lunch selection
indicates that the client understands the restriction?
A. Ham and cheese sandwich on rye bread with pickles.
B. Grilled chicken breast with steamed broccoli and brown rice.
C. Pepperoni pizza with a side salad and ranch dressing.
D. Canned tomato soup with saltine crackers.
Correct Answer: B
Rationale: Grilled chicken, steamed broccoli, and brown rice are naturally low in sodium and nutrient-
dense. Processed meats like ham and pepperoni are extremely high in sodium due to curing and
preservation. Canned soups and pickles also contain excessive salt levels that can lead to fluid overload in
CHF patients. Choosing fresh, whole foods allows the patient to stay within the strict 2-gram daily limit.
Proper adherence to this diet is critical for managing peripheral edema and pulmonary congestion.
7. Which of the following is the most effective nutritional intervention for a client with Diverticulosis to
prevent the development of Diverticulitis?
A. High-protein, low-carbohydrate diet.
B. Low-residue diet with limited fruit consumption.
C. Clear liquid diet until symptoms disappear.
D. High-fiber diet with adequate fluid intake.
Chamberlain University Updated and Latest Questions and
Correct Answers with Rationale
1. A client with type 1 diabetes mellitus is being taught how to manage their diet during illness. Which
instruction should the nurse include regarding carbohydrate intake?
A. Discontinue all carbohydrate intake until the fever subsides.
B. Increase carbohydrate intake by 50% to compensate for increased metabolic demand.
C. Substitute regular carbohydrate choices with liquid sources if solids are not tolerated.
D. Consume only high-protein liquids to prevent muscle wasting during illness.
Correct Answer: C
Rationale: During illness, it is vital for patients with type 1 diabetes to continue consuming
carbohydrates to prevent hypoglycemia and ketoacidosis. If solid foods are not tolerated, the client
should use liquid or semi-liquid sources like juice or gelatin to meet their needs. Standard protocol
suggests 10 to 15 grams of carbohydrates every 1 to 2 hours while awake. Monitoring blood glucose
frequently is also necessary to adjust insulin doses as metabolic stress increases requirements. This
approach ensures the body has enough glucose to prevent the breakdown of fats for energy.
2. The nurse is reviewing the laboratory results for a client with chronic kidney disease and hypertension.
Which dietary mineral restriction is most critical to prevent further fluid retention and cardiovascular
strain?
A. Sodium
B. Calcium
C. Magnesium
,D. Zinc
Correct Answer: A
Rationale: Sodium restriction is essential in managing chronic kidney disease and hypertension because
sodium causes water retention. Excessive fluid volume increases the workload on the heart and raises
blood pressure levels significantly. Most therapeutic diets for these conditions limit sodium to less than
2,300 milligrams per day. Reducing sodium helps mitigate edema and prevents the progression of
congestive heart failure. Clients are encouraged to avoid processed foods and use herbs for seasoning
instead of table salt.
3. Which dietary modification is most appropriate for a patient diagnosed with Celiac disease to prevent
malabsorption and intestinal damage?
A. Eliminate all dairy products containing lactose.
B. Increase intake of soluble fiber to slow digestion.
C. Avoid products containing wheat, barley, and rye.
D. Follow a low-FODMAP diet to reduce gas and bloating.
Correct Answer: C
Rationale: Celiac disease is an autoimmune disorder triggered by the ingestion of gluten found in specific
grains. Ingesting wheat, barley, or rye causes an inflammatory response that damages the villi of the
small intestine. This damage leads to severe malabsorption of nutrients and various gastrointestinal
symptoms. Strict adherence to a gluten-free diet is the only effective treatment to allow the intestinal
mucosa to heal. Patients must be educated on reading labels carefully to identify hidden sources of gluten
in processed items.
,4. A client with Dumping Syndrome following a gastric bypass surgery should be instructed to follow which
nutritional guideline?
A. Eat small, frequent meals and avoid liquids during mealtime.
B. Consume high-sugar liquids to maintain energy levels.
C. Drink at least 12 ounces of water with every meal.
D. Lie down for 30 minutes before eating to slow motility.
Correct Answer: A
Rationale: Dumping syndrome occurs when food moves too rapidly from the stomach into the small
intestine. Consuming liquids with meals speeds up this process and should be avoided by waiting 30 to
60 minutes after eating. Small, frequent meals help manage the volume of food and reduce the osmotic
load in the duodenum. Patients should also avoid high-sugar foods which contribute to the rapid shift of
fluid into the gut. Lying down after meals, rather than before, can help slow the movement of food
through the digestive tract.
5. Which food should a nurse recommend to a client on a DASH (Dietary Approaches to Stop Hypertension)
diet to increase potassium intake?
A. Canned vegetable soup
B. Fresh bananas and spinach
C. White bread and pasta
D. Processed deli meats
Correct Answer: B
Rationale: The DASH diet emphasizes high intake of potassium, calcium, and magnesium to help lower
blood pressure. Fresh fruits like bananas and leafy greens like spinach are excellent sources of naturally
, occurring potassium. High potassium intake helps the kidneys excrete sodium and eases tension in the
blood vessel walls. In contrast, canned soups and deli meats are typically very high in sodium and should
be avoided. Following these guidelines helps reduce the risk of stroke and other cardiovascular
complications.
6. A client with Congestive Heart Failure (CHF) is prescribed a 2-gram sodium diet. Which lunch selection
indicates that the client understands the restriction?
A. Ham and cheese sandwich on rye bread with pickles.
B. Grilled chicken breast with steamed broccoli and brown rice.
C. Pepperoni pizza with a side salad and ranch dressing.
D. Canned tomato soup with saltine crackers.
Correct Answer: B
Rationale: Grilled chicken, steamed broccoli, and brown rice are naturally low in sodium and nutrient-
dense. Processed meats like ham and pepperoni are extremely high in sodium due to curing and
preservation. Canned soups and pickles also contain excessive salt levels that can lead to fluid overload in
CHF patients. Choosing fresh, whole foods allows the patient to stay within the strict 2-gram daily limit.
Proper adherence to this diet is critical for managing peripheral edema and pulmonary congestion.
7. Which of the following is the most effective nutritional intervention for a client with Diverticulosis to
prevent the development of Diverticulitis?
A. High-protein, low-carbohydrate diet.
B. Low-residue diet with limited fruit consumption.
C. Clear liquid diet until symptoms disappear.
D. High-fiber diet with adequate fluid intake.
