JERSEY COLLEGE NUTRITION MIDTERM
EXAM 2026 PRACTICE QUESTIONS AND
DETAILED CORRECT ANSWERS | COMPLETE
NUTRITION REVIEW GUIDE AND TEST PREP
• This document contains comprehensive multiple-choice questions designed for
Jersey College Nutrition Midterm Exam 2026
• Study this material by reviewing each question, attempting to answer before
reading the EXPERT RATIONALE, then analyzing the detailed explanations to
reinforce learning
1) A 45-year-old patient presents with muscle weakness and cardiac
arrhythmias. Laboratory findings show serum potassium of 2.8 mEq/L. Which
of the following is the primary mechanism of action for potassium in
maintaining cardiac function?
A) Inhibiting sodium-potassium pump activity
B) Maintaining the resting membrane potential and conducting electrical impulses
C) Increasing intracellular calcium concentration
D) Promoting glycogen synthesis in cardiac cells
E) Enhancing mitochondrial ATP production exclusively
CORRECT ANSWER: B) Maintaining the resting membrane potential and
conducting electrical impulses
Potassium is essential for establishing the resting membrane potential and
facilitating the conduction of electrical impulses in cardiac tissue. The sodium-
potassium pump (Na+/K+-ATPase) maintains the high intracellular potassium
concentration necessary for proper cardiac function. Hypokalemia (low potassium)
disrupts this electrical gradient, leading to arrhythmias and muscle weakness. While
potassium does interact with the Na+/K+-ATPase pump, it does not inhibit it; rather,
it works in conjunction with it. Calcium and ATP have roles in cardiac function but
are not the primary mechanisms of potassium's action in this context.
,2) Which nutrient is considered a cofactor for the enzyme carboxypeptidase,
which is responsible for breaking down proteins in the small intestine?
A) Vitamin B12
B) Zinc
C) Magnesium
D) Iron
E) Selenium
CORRECT ANSWER: B) Zinc
Zinc functions as a critical cofactor for carboxypeptidase, a pancreatic exopeptidase
that removes amino acids from the carboxyl terminus of protein chains during
digestion. Without adequate zinc, protein digestion becomes impaired, potentially
leading to malabsorption and protein deficiency. Vitamin B12 is involved in
methylation reactions and DNA synthesis, not protein digestion. Magnesium is
important for many enzymatic reactions but is not the cofactor for
carboxypeptidase. Iron functions in oxygen transport and electron transfer, while
selenium is incorporated into selenoproteins and is not a cofactor for
carboxypeptidase.
3) A patient with cystic fibrosis is experiencing fat malabsorption and
deficiency in fat-soluble vitamins. Which of the following best explains the
mechanism of fat malabsorption in cystic fibrosis?
A) Decreased production of gastric lipase in the stomach
B) Impaired pancreatic enzyme secretion and blocked pancreatic ducts
C) Excessive bile acid deconjugation in the terminal ileum
D) Increased intestinal motility reducing contact time with the intestinal lining
E) Deficiency of intestinal brush border lipases
CORRECT ANSWER: B) Impaired pancreatic enzyme secretion and blocked
pancreatic ducts
,Cystic fibrosis is caused by mutations in the CFTR gene, leading to thick, viscous
secretions that block pancreatic ducts and prevent the secretion of pancreatic
enzymes (lipase, amylase, proteases) into the small intestine. Without these
enzymes, fat digestion and absorption are severely impaired, resulting in
steatorrhea and fat-soluble vitamin malabsorption (vitamins A, D, E, and K). Gastric
lipase is produced, but the major issue is at the pancreatic level. Bile acid
metabolism is typically normal in cystic fibrosis. Intestinal motility is not the primary
problem. While intestinal lipases exist, they contribute minimally to overall fat
digestion compared to pancreatic lipase, which accounts for the majority of fat
digestion.
4) A 62-year-old male with type 2 diabetes mellitus has a fasting blood glucose
of 145 mg/dL and HbA1c of 8.5%. His dietitian recommends increasing fiber
intake. What is the primary mechanism by which soluble fiber helps improve
glycemic control?
A) Decreasing gastric pH and inactivating digestive enzymes
B) Slowing gastric emptying and reducing the rate of glucose absorption
C) Inhibiting the release of insulin from pancreatic beta cells
D) Increasing renal glucose excretion through osmotic effects
E) Promoting gluconeogenesis in the liver
CORRECT ANSWER: B) Slowing gastric emptying and reducing the rate of
glucose absorption
Soluble fiber forms a viscous gel in the small intestine, which slows gastric emptying
and delays glucose absorption. This results in a slower, more gradual rise in blood
glucose levels, reducing postprandial hyperglycemia and improving overall glycemic
control. The slower absorption also allows for better insulin secretion matching,
reducing insulin resistance. Fiber does not significantly alter gastric pH or inactivate
enzymes. Fiber does not inhibit insulin secretion; in fact, the improved glycemic
response may reduce insulin demand over time. Fiber increases fecal bulk and may
have minor osmotic effects, but renal glucose excretion is not the primary
, mechanism. Soluble fiber does not promote gluconeogenesis; it reduces glucose
absorption, which may slightly reduce the need for hepatic glucose production.
5) A 28-year-old vegetarian woman presents with fatigue, dyspnea, and a
hemoglobin level of 7.2 g/dL. She reports consuming primarily plant-based
proteins and limited legumes. Which form of iron present in plant-based
foods has the lowest bioavailability?
A) Heme iron
B) Non-heme iron
C) Ferrous iron
D) Iron complexed with phytates
E) Iron in fortified grains
CORRECT ANSWER: D) Iron complexed with phytates
Non-heme iron (found in plant-based foods) has inherently lower bioavailability
compared to heme iron (found in animal products), with absorption rates of 2-20%
versus 15-35%. Phytates, oxalates, and polyphenols are dietary inhibitors that bind
to non-heme iron and further reduce its absorption. When non-heme iron is
complexed with phytates, bioavailability is minimized. Heme iron is only found in
animal products, not plant-based foods. While iron can be in ferrous (Fe2+) or ferric
(Fe3+) form, ferrous iron actually has better absorption than ferric iron. Fortified
grains contain iron that is more bioavailable than iron naturally occurring and
complexed with phytates, though still less bioavailable than heme iron. To improve
non-heme iron absorption, vitamin C should be consumed with plant-based iron
sources.
6) A 35-year-old patient with severe liver cirrhosis is prescribed a protein-
restricted diet due to concerns about hepatic encephalopathy. The dietitian
recommends emphasizing branched-chain amino acids (BCAAs) over aromatic
EXAM 2026 PRACTICE QUESTIONS AND
DETAILED CORRECT ANSWERS | COMPLETE
NUTRITION REVIEW GUIDE AND TEST PREP
• This document contains comprehensive multiple-choice questions designed for
Jersey College Nutrition Midterm Exam 2026
• Study this material by reviewing each question, attempting to answer before
reading the EXPERT RATIONALE, then analyzing the detailed explanations to
reinforce learning
1) A 45-year-old patient presents with muscle weakness and cardiac
arrhythmias. Laboratory findings show serum potassium of 2.8 mEq/L. Which
of the following is the primary mechanism of action for potassium in
maintaining cardiac function?
A) Inhibiting sodium-potassium pump activity
B) Maintaining the resting membrane potential and conducting electrical impulses
C) Increasing intracellular calcium concentration
D) Promoting glycogen synthesis in cardiac cells
E) Enhancing mitochondrial ATP production exclusively
CORRECT ANSWER: B) Maintaining the resting membrane potential and
conducting electrical impulses
Potassium is essential for establishing the resting membrane potential and
facilitating the conduction of electrical impulses in cardiac tissue. The sodium-
potassium pump (Na+/K+-ATPase) maintains the high intracellular potassium
concentration necessary for proper cardiac function. Hypokalemia (low potassium)
disrupts this electrical gradient, leading to arrhythmias and muscle weakness. While
potassium does interact with the Na+/K+-ATPase pump, it does not inhibit it; rather,
it works in conjunction with it. Calcium and ATP have roles in cardiac function but
are not the primary mechanisms of potassium's action in this context.
,2) Which nutrient is considered a cofactor for the enzyme carboxypeptidase,
which is responsible for breaking down proteins in the small intestine?
A) Vitamin B12
B) Zinc
C) Magnesium
D) Iron
E) Selenium
CORRECT ANSWER: B) Zinc
Zinc functions as a critical cofactor for carboxypeptidase, a pancreatic exopeptidase
that removes amino acids from the carboxyl terminus of protein chains during
digestion. Without adequate zinc, protein digestion becomes impaired, potentially
leading to malabsorption and protein deficiency. Vitamin B12 is involved in
methylation reactions and DNA synthesis, not protein digestion. Magnesium is
important for many enzymatic reactions but is not the cofactor for
carboxypeptidase. Iron functions in oxygen transport and electron transfer, while
selenium is incorporated into selenoproteins and is not a cofactor for
carboxypeptidase.
3) A patient with cystic fibrosis is experiencing fat malabsorption and
deficiency in fat-soluble vitamins. Which of the following best explains the
mechanism of fat malabsorption in cystic fibrosis?
A) Decreased production of gastric lipase in the stomach
B) Impaired pancreatic enzyme secretion and blocked pancreatic ducts
C) Excessive bile acid deconjugation in the terminal ileum
D) Increased intestinal motility reducing contact time with the intestinal lining
E) Deficiency of intestinal brush border lipases
CORRECT ANSWER: B) Impaired pancreatic enzyme secretion and blocked
pancreatic ducts
,Cystic fibrosis is caused by mutations in the CFTR gene, leading to thick, viscous
secretions that block pancreatic ducts and prevent the secretion of pancreatic
enzymes (lipase, amylase, proteases) into the small intestine. Without these
enzymes, fat digestion and absorption are severely impaired, resulting in
steatorrhea and fat-soluble vitamin malabsorption (vitamins A, D, E, and K). Gastric
lipase is produced, but the major issue is at the pancreatic level. Bile acid
metabolism is typically normal in cystic fibrosis. Intestinal motility is not the primary
problem. While intestinal lipases exist, they contribute minimally to overall fat
digestion compared to pancreatic lipase, which accounts for the majority of fat
digestion.
4) A 62-year-old male with type 2 diabetes mellitus has a fasting blood glucose
of 145 mg/dL and HbA1c of 8.5%. His dietitian recommends increasing fiber
intake. What is the primary mechanism by which soluble fiber helps improve
glycemic control?
A) Decreasing gastric pH and inactivating digestive enzymes
B) Slowing gastric emptying and reducing the rate of glucose absorption
C) Inhibiting the release of insulin from pancreatic beta cells
D) Increasing renal glucose excretion through osmotic effects
E) Promoting gluconeogenesis in the liver
CORRECT ANSWER: B) Slowing gastric emptying and reducing the rate of
glucose absorption
Soluble fiber forms a viscous gel in the small intestine, which slows gastric emptying
and delays glucose absorption. This results in a slower, more gradual rise in blood
glucose levels, reducing postprandial hyperglycemia and improving overall glycemic
control. The slower absorption also allows for better insulin secretion matching,
reducing insulin resistance. Fiber does not significantly alter gastric pH or inactivate
enzymes. Fiber does not inhibit insulin secretion; in fact, the improved glycemic
response may reduce insulin demand over time. Fiber increases fecal bulk and may
have minor osmotic effects, but renal glucose excretion is not the primary
, mechanism. Soluble fiber does not promote gluconeogenesis; it reduces glucose
absorption, which may slightly reduce the need for hepatic glucose production.
5) A 28-year-old vegetarian woman presents with fatigue, dyspnea, and a
hemoglobin level of 7.2 g/dL. She reports consuming primarily plant-based
proteins and limited legumes. Which form of iron present in plant-based
foods has the lowest bioavailability?
A) Heme iron
B) Non-heme iron
C) Ferrous iron
D) Iron complexed with phytates
E) Iron in fortified grains
CORRECT ANSWER: D) Iron complexed with phytates
Non-heme iron (found in plant-based foods) has inherently lower bioavailability
compared to heme iron (found in animal products), with absorption rates of 2-20%
versus 15-35%. Phytates, oxalates, and polyphenols are dietary inhibitors that bind
to non-heme iron and further reduce its absorption. When non-heme iron is
complexed with phytates, bioavailability is minimized. Heme iron is only found in
animal products, not plant-based foods. While iron can be in ferrous (Fe2+) or ferric
(Fe3+) form, ferrous iron actually has better absorption than ferric iron. Fortified
grains contain iron that is more bioavailable than iron naturally occurring and
complexed with phytates, though still less bioavailable than heme iron. To improve
non-heme iron absorption, vitamin C should be consumed with plant-based iron
sources.
6) A 35-year-old patient with severe liver cirrhosis is prescribed a protein-
restricted diet due to concerns about hepatic encephalopathy. The dietitian
recommends emphasizing branched-chain amino acids (BCAAs) over aromatic
