NR 228 Final Exam: Nutrition, Health & Wellness -
Chamberlain University Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is teaching a client with iron-deficiency anemia about enhancing the absorption of non-heme
iron. Which food combination should the nurse recommend to maximize bioavailability?
A. Whole grain toast with a glass of calcium-fortified milk
B. Spinach salad with sliced strawberries and lemon vinaigrette
C. Beef liver sautéed with onions and mushrooms
D. Black beans consumed with a cup of hot black tea
Correct Answer: B
Rationale: Non-heme iron found in plant sources is less readily absorbed than heme iron from animal
products. Vitamin C, found in strawberries and lemon juice, facilitates the conversion of ferric iron to the
more absorbable ferrous form. This chemical reaction significantly improves the uptake of iron within
the small intestine. Conversely, calcium and tannins in tea can actually inhibit the absorption of non-
heme iron. Therefore, combining plant-based iron with ascorbic acid is the most effective strategy for this
client.
2. A client is diagnosed with Metabolic Syndrome. Which clinical finding would the nurse expect to observe
based on the diagnostic criteria for this condition?
A. Low serum triglycerides and high HDL cholesterol
B. Body mass index (BMI) less than 25 kg/m²
C. Fasting blood glucose level of 85 mg/dL
D. Blood pressure reading consistently at or above 130/85 mmHg
,Correct Answer: D
Rationale: Metabolic syndrome consists of a cluster of risk factors that increase the likelihood of
developing cardiovascular disease and type 2 diabetes. One of the primary diagnostic criteria is a blood
pressure reading of 130/85 mmHg or higher. Other factors include abdominal obesity, elevated fasting
glucose, and high triglyceride levels. Low HDL cholesterol is also a significant marker for this metabolic
disorder. Identifying these factors early allows for targeted lifestyle interventions to prevent serious
health complications.
3. When planning care for a client with Type 1 Diabetes Mellitus, the nurse teaches carbohydrate counting.
If the client’s insulin-to-carb ratio is 1:15, how many units of rapid-acting insulin are needed for a meal
containing 60 grams of carbohydrates?
A. 2 units
B. 4 units
C. 6 units
D. 1 unit
Correct Answer: B
Rationale: Carbohydrate counting is a precise method for managing postprandial glucose levels in
diabetic patients. The insulin-to-carb ratio determines exactly how much insulin is required to cover the
glucose load of a meal. By dividing the total grams of carbohydrates (60) by the ratio factor (15), the
resulting dose is 4 units. This calculation helps maintain glycemic control while providing the client with
dietary flexibility. Accurate counting is essential to prevent both hyperglycemia and life-threatening
hypoglycemia.
,4. A nurse is administering enteral nutrition via a nasogastric tube. Which intervention is most critical to
prevent the complication of aspiration pneumonia?
A. Maintaining the head of the bed at an angle of at least 30 to 45 degrees
B. Checking the gastric residual volume every 24 hours
C. Warming the formula to room temperature before administration
D. Flushing the tube with 30 mL of warm water every 4 hours
Correct Answer: A
Rationale: Aspiration is a serious risk for clients receiving enteral tube feedings due to potential reflux.
Elevating the head of the bed utilizes gravity to keep formula in the stomach and away from the airway.
This position should be maintained during the feeding and for at least 30 to 60 minutes afterward. While
flushing the tube maintains patency, it does not directly prevent the inhalation of gastric contents. Proper
positioning remains the gold standard intervention for ensuring pulmonary safety during liquid nutrition
therapy.
5. A client with Celiac disease is being discharged with a list of allowed foods. Which of the following grains
is safe for this client to consume?
A. Barley
B. Rye
C. Spelt
D. Quinoa
Correct Answer: D
Rationale: Celiac disease is an autoimmune reaction to gluten, which is found in wheat, barley, and rye.
Quinoa is a pseudo-cereal that is naturally gluten-free and safe for these patients. Consuming even small
, amounts of gluten can cause significant damage to the intestinal villi in affected individuals. Spelt is a
variety of wheat and must be strictly avoided to prevent malabsorption. Educating clients on identifying
hidden sources of gluten is vital for long-term health management.
6. A woman in her first trimester of pregnancy asks why she needs to take a folic acid supplement. What is
the best response by the nurse?
A. Folic acid increases the absorption of vitamin D for fetal growth.
B. It helps in the formation of the baby’s bones and teeth.
C. It prevents maternal gestational diabetes by regulating glucose.
D. Folic acid is essential to prevent neural tube defects such as spina bifida.
Correct Answer: D
Rationale: Folic acid plays a critical role in DNA synthesis and the closure of the neural tube during early
development. Adequate intake before and during the first few weeks of pregnancy drastically reduces the
risk of spina bifida and anencephaly. The neural tube typically closes by the 28th day after conception,
often before a woman knows she is pregnant. Because of this, supplementation is recommended for all
women of childbearing age. This nutrient is a primary focus of prenatal nutritional health promotion.
7. A client with stage 4 Chronic Kidney Disease (CKD) has a potassium level of 5.8 mEq/L. Which food item
should the nurse instruct the client to avoid?
A. Apples
B. Baked potatoes
C. Green beans
D. White rice
Correct Answer: B
Chamberlain University Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is teaching a client with iron-deficiency anemia about enhancing the absorption of non-heme
iron. Which food combination should the nurse recommend to maximize bioavailability?
A. Whole grain toast with a glass of calcium-fortified milk
B. Spinach salad with sliced strawberries and lemon vinaigrette
C. Beef liver sautéed with onions and mushrooms
D. Black beans consumed with a cup of hot black tea
Correct Answer: B
Rationale: Non-heme iron found in plant sources is less readily absorbed than heme iron from animal
products. Vitamin C, found in strawberries and lemon juice, facilitates the conversion of ferric iron to the
more absorbable ferrous form. This chemical reaction significantly improves the uptake of iron within
the small intestine. Conversely, calcium and tannins in tea can actually inhibit the absorption of non-
heme iron. Therefore, combining plant-based iron with ascorbic acid is the most effective strategy for this
client.
2. A client is diagnosed with Metabolic Syndrome. Which clinical finding would the nurse expect to observe
based on the diagnostic criteria for this condition?
A. Low serum triglycerides and high HDL cholesterol
B. Body mass index (BMI) less than 25 kg/m²
C. Fasting blood glucose level of 85 mg/dL
D. Blood pressure reading consistently at or above 130/85 mmHg
,Correct Answer: D
Rationale: Metabolic syndrome consists of a cluster of risk factors that increase the likelihood of
developing cardiovascular disease and type 2 diabetes. One of the primary diagnostic criteria is a blood
pressure reading of 130/85 mmHg or higher. Other factors include abdominal obesity, elevated fasting
glucose, and high triglyceride levels. Low HDL cholesterol is also a significant marker for this metabolic
disorder. Identifying these factors early allows for targeted lifestyle interventions to prevent serious
health complications.
3. When planning care for a client with Type 1 Diabetes Mellitus, the nurse teaches carbohydrate counting.
If the client’s insulin-to-carb ratio is 1:15, how many units of rapid-acting insulin are needed for a meal
containing 60 grams of carbohydrates?
A. 2 units
B. 4 units
C. 6 units
D. 1 unit
Correct Answer: B
Rationale: Carbohydrate counting is a precise method for managing postprandial glucose levels in
diabetic patients. The insulin-to-carb ratio determines exactly how much insulin is required to cover the
glucose load of a meal. By dividing the total grams of carbohydrates (60) by the ratio factor (15), the
resulting dose is 4 units. This calculation helps maintain glycemic control while providing the client with
dietary flexibility. Accurate counting is essential to prevent both hyperglycemia and life-threatening
hypoglycemia.
,4. A nurse is administering enteral nutrition via a nasogastric tube. Which intervention is most critical to
prevent the complication of aspiration pneumonia?
A. Maintaining the head of the bed at an angle of at least 30 to 45 degrees
B. Checking the gastric residual volume every 24 hours
C. Warming the formula to room temperature before administration
D. Flushing the tube with 30 mL of warm water every 4 hours
Correct Answer: A
Rationale: Aspiration is a serious risk for clients receiving enteral tube feedings due to potential reflux.
Elevating the head of the bed utilizes gravity to keep formula in the stomach and away from the airway.
This position should be maintained during the feeding and for at least 30 to 60 minutes afterward. While
flushing the tube maintains patency, it does not directly prevent the inhalation of gastric contents. Proper
positioning remains the gold standard intervention for ensuring pulmonary safety during liquid nutrition
therapy.
5. A client with Celiac disease is being discharged with a list of allowed foods. Which of the following grains
is safe for this client to consume?
A. Barley
B. Rye
C. Spelt
D. Quinoa
Correct Answer: D
Rationale: Celiac disease is an autoimmune reaction to gluten, which is found in wheat, barley, and rye.
Quinoa is a pseudo-cereal that is naturally gluten-free and safe for these patients. Consuming even small
, amounts of gluten can cause significant damage to the intestinal villi in affected individuals. Spelt is a
variety of wheat and must be strictly avoided to prevent malabsorption. Educating clients on identifying
hidden sources of gluten is vital for long-term health management.
6. A woman in her first trimester of pregnancy asks why she needs to take a folic acid supplement. What is
the best response by the nurse?
A. Folic acid increases the absorption of vitamin D for fetal growth.
B. It helps in the formation of the baby’s bones and teeth.
C. It prevents maternal gestational diabetes by regulating glucose.
D. Folic acid is essential to prevent neural tube defects such as spina bifida.
Correct Answer: D
Rationale: Folic acid plays a critical role in DNA synthesis and the closure of the neural tube during early
development. Adequate intake before and during the first few weeks of pregnancy drastically reduces the
risk of spina bifida and anencephaly. The neural tube typically closes by the 28th day after conception,
often before a woman knows she is pregnant. Because of this, supplementation is recommended for all
women of childbearing age. This nutrient is a primary focus of prenatal nutritional health promotion.
7. A client with stage 4 Chronic Kidney Disease (CKD) has a potassium level of 5.8 mEq/L. Which food item
should the nurse instruct the client to avoid?
A. Apples
B. Baked potatoes
C. Green beans
D. White rice
Correct Answer: B
