NR-228 – Nutrition, Health & Wellness Explores
nutritional requirements, wellness promotion, disease
prevention, healthy lifestyles, dietary planning, and
evidence-based health interventions.
1. Which macronutrient provides the most energy per gram?
A. Carbohydrate
B. Protein
C. Fat
D. Alcohol
Correct Answer: C
Rationale: Fat provides 9 kcal/g, compared to carbohydrate and protein (4 kcal/g)
and alcohol (7 kcal/g). Fats are the most energy-dense macronutrient.
2. A client asks which type of carbohydrate is most effective for maintaining
stable blood glucose levels. The nurse should recommend:
A. White bread
B. Sucrose
C. Whole oats with fiber
D. Fruit juice
Correct Answer: C
Rationale: Complex carbohydrates with soluble fiber (whole oats) slow digestion
and absorption, preventing rapid blood glucose spikes. White bread, sucrose, and
fruit juice are high-glycemic.
3. The recommended daily allowance (RDA) for protein for a healthy
sedentary adult is:
A. 0.4 g/kg body weight
B. 0.8 g/kg body weight
C. 1.2 g/kg body weight
D. 2.0 g/kg body weight
Correct Answer: B
Rationale: RDA for protein is 0.8 g per kg of body weight for most healthy adults.
Athletes or illness may require higher (1.2-2.0 g/kg).
,4. A client with heart failure is advised to limit sodium intake. Which food
item contains the highest amount of hidden sodium?
A. Fresh apple
B. Canned vegetable soup
C. Unsalted almonds
D. Brown rice
Correct Answer: B
Rationale: Processed and canned foods (soup, vegetables, sauces) are major
sources of added sodium. Fresh fruits, unsalted nuts, and unprocessed grains are
naturally low in sodium.
5. Which vitamin is synthesized in the skin upon exposure to sunlight?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin E
Correct Answer: C
Rationale: Vitamin D (cholecalciferol) is synthesized from 7-dehydrocholesterol
in the skin with UVB exposure. It is then activated in the liver and kidneys.
6. A vegan client is at risk for deficiency of which vitamin primarily found in
animal products?
A. Thiamin (B1)
B. Vitamin C
C. Vitamin B12 (cobalamin)
D. Folate
Correct Answer: C
Rationale: Vitamin B12 is naturally found almost exclusively in animal foods
(meat, dairy, eggs). Vegans need fortified foods or supplements. Thiamin, vitamin
C, and folate are abundant in plants.
7. The nurse teaches a client that trans fats should be limited because they:
A. Increase HDL and decrease LDL
B. Decrease HDL and increase LDL
C. Have no effect on cholesterol
D. Only affect triglycerides
Correct Answer: B
Rationale: Trans fats raise LDL (bad cholesterol) and lower HDL (good
, cholesterol), increasing cardiovascular risk. They are found in partially
hydrogenated oils.
8. A client with osteoporosis should increase intake of which two nutrients?
A. Calcium and vitamin D
B. Iron and vitamin C
C. Magnesium and vitamin K
D. Phosphorus and zinc
Correct Answer: A
Rationale: Calcium is the primary mineral in bone; vitamin D enhances calcium
absorption. Together they are critical for bone density. Iron/vitamin C are for
anemia; magnesium/vitamin K also play roles but are not the primary pair.
9. Which of the following is a complete protein source?
A. Lentils
B. Quinoa
C. Peanut butter
D. Whole wheat bread
Correct Answer: B
Rationale: A complete protein contains all nine essential amino acids in adequate
amounts. Quinoa is a plant-based complete protein. Lentils, peanut butter, and
wheat are incomplete (lack one or more essential amino acids).
10. The nurse is evaluating a client’s food label. The label states “Total Fat
10g, Saturated Fat 3g, Trans Fat 0g.” What percentage of total calories from
fat is provided if the product has 200 calories?
A. 15%
B. 30%
C. 45%
D. 60%
Correct Answer: C
Rationale: Fat provides 9 kcal/g. 10g fat × 9 = 90 kcal from fat. 90/200 total kcal
= 0.45 = 45%. Acceptable range is 20-35% of calories from fat, so 45% is high.
11. A client reports consuming a high-protein, low-carbohydrate diet for
weight loss. The nurse should advise that very low carbohydrate intake may
lead to:
A. Increased glycogen storage
B. Metabolic alkalosis
nutritional requirements, wellness promotion, disease
prevention, healthy lifestyles, dietary planning, and
evidence-based health interventions.
1. Which macronutrient provides the most energy per gram?
A. Carbohydrate
B. Protein
C. Fat
D. Alcohol
Correct Answer: C
Rationale: Fat provides 9 kcal/g, compared to carbohydrate and protein (4 kcal/g)
and alcohol (7 kcal/g). Fats are the most energy-dense macronutrient.
2. A client asks which type of carbohydrate is most effective for maintaining
stable blood glucose levels. The nurse should recommend:
A. White bread
B. Sucrose
C. Whole oats with fiber
D. Fruit juice
Correct Answer: C
Rationale: Complex carbohydrates with soluble fiber (whole oats) slow digestion
and absorption, preventing rapid blood glucose spikes. White bread, sucrose, and
fruit juice are high-glycemic.
3. The recommended daily allowance (RDA) for protein for a healthy
sedentary adult is:
A. 0.4 g/kg body weight
B. 0.8 g/kg body weight
C. 1.2 g/kg body weight
D. 2.0 g/kg body weight
Correct Answer: B
Rationale: RDA for protein is 0.8 g per kg of body weight for most healthy adults.
Athletes or illness may require higher (1.2-2.0 g/kg).
,4. A client with heart failure is advised to limit sodium intake. Which food
item contains the highest amount of hidden sodium?
A. Fresh apple
B. Canned vegetable soup
C. Unsalted almonds
D. Brown rice
Correct Answer: B
Rationale: Processed and canned foods (soup, vegetables, sauces) are major
sources of added sodium. Fresh fruits, unsalted nuts, and unprocessed grains are
naturally low in sodium.
5. Which vitamin is synthesized in the skin upon exposure to sunlight?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin E
Correct Answer: C
Rationale: Vitamin D (cholecalciferol) is synthesized from 7-dehydrocholesterol
in the skin with UVB exposure. It is then activated in the liver and kidneys.
6. A vegan client is at risk for deficiency of which vitamin primarily found in
animal products?
A. Thiamin (B1)
B. Vitamin C
C. Vitamin B12 (cobalamin)
D. Folate
Correct Answer: C
Rationale: Vitamin B12 is naturally found almost exclusively in animal foods
(meat, dairy, eggs). Vegans need fortified foods or supplements. Thiamin, vitamin
C, and folate are abundant in plants.
7. The nurse teaches a client that trans fats should be limited because they:
A. Increase HDL and decrease LDL
B. Decrease HDL and increase LDL
C. Have no effect on cholesterol
D. Only affect triglycerides
Correct Answer: B
Rationale: Trans fats raise LDL (bad cholesterol) and lower HDL (good
, cholesterol), increasing cardiovascular risk. They are found in partially
hydrogenated oils.
8. A client with osteoporosis should increase intake of which two nutrients?
A. Calcium and vitamin D
B. Iron and vitamin C
C. Magnesium and vitamin K
D. Phosphorus and zinc
Correct Answer: A
Rationale: Calcium is the primary mineral in bone; vitamin D enhances calcium
absorption. Together they are critical for bone density. Iron/vitamin C are for
anemia; magnesium/vitamin K also play roles but are not the primary pair.
9. Which of the following is a complete protein source?
A. Lentils
B. Quinoa
C. Peanut butter
D. Whole wheat bread
Correct Answer: B
Rationale: A complete protein contains all nine essential amino acids in adequate
amounts. Quinoa is a plant-based complete protein. Lentils, peanut butter, and
wheat are incomplete (lack one or more essential amino acids).
10. The nurse is evaluating a client’s food label. The label states “Total Fat
10g, Saturated Fat 3g, Trans Fat 0g.” What percentage of total calories from
fat is provided if the product has 200 calories?
A. 15%
B. 30%
C. 45%
D. 60%
Correct Answer: C
Rationale: Fat provides 9 kcal/g. 10g fat × 9 = 90 kcal from fat. 90/200 total kcal
= 0.45 = 45%. Acceptable range is 20-35% of calories from fat, so 45% is high.
11. A client reports consuming a high-protein, low-carbohydrate diet for
weight loss. The nurse should advise that very low carbohydrate intake may
lead to:
A. Increased glycogen storage
B. Metabolic alkalosis
