HESI NUTRITION EXAM ACTUAL EXAM | ALL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES | GRADED A+ | PROFESSOR VERIFIED
The parents of a 6-year-old child with celiac disease tell the school nurse that their child
becomes dejected because she is not able to eat snack foods like the rest of her class
and friends. What snack can the nurse recommend that is safe for the child to eat -
ANSWERtortilla chips
Products composed of corn, rice, and millet do not contain gluten and are permitted on
a low-gluten diet; tortilla chips are made from corn flour. Pretzels contain wheat flour,
which is not permitted on a low-gluten diet; products containing rye, oats, and barley are
also restricted. Oatmeal cookies contain oats, which are not permitted on a low-gluten
diet. Peanut butter crackers contain wheat flour, which is not permitted on a low-gluten
diet.
A pathology report states that a client's urinary calculus is composed of uric acid. Which
food item should the nurse instruct the client to avoid? - ANSWERliver
Uric acid stones are controlled by a low-purine diet. Foods high in purine, such as organ
meats and extracts, should be avoided. Milk should be avoided with calcium, not uric
acid, stones. Cheese or animal protein should be avoided with cystine, not uric acid,
stones. Vegetables do not have to be avoided.
The nurse is teaching a class about nutrition to a group of adolescents. Taking into
consideration the prevalence of overweight teenagers, what is the best recommendation
the nurse can make? - ANSWERdecrease fast food
Eating a variety of healthful foods instead of a fast-food diet that is high in fat and
carbohydrates helps decrease excess weight and increase energy with which to engage
in physical activities. Joining a gym is expensive and unnecessary. Physical activity can
be achieved in the schoolyard or at home. A multivitamin will not promote weight loss.
Vitamins and minerals are best obtained in a balanced diet. Diet soft drinks do not
contribute to obesity.
A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a
result of a genetic deficiency, should the nurse consider to be the cause of the client's
discomfort? - ANSWERlactase
Milk and milk products are not tolerated well because they contain lactose, a sugar that
is converted to galactose by lactase. Sucrase assists in the digestion of sucrose, which
is not a milk sugar. Maltase assists in the digestion of maltose, which is not a milk
sugar. Amylase assists in the digestion of starch, which is not a milk sugar
A client presents to the emergency department with weakness and dizziness. The blood
pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound
(1.4 kilogram) loss in two days. The weather has been hot. Which condition should the
nurse conclude is the priority for this client? - ANSWERdeficient fluid volume
,The low blood pressure indicates hypovolemia, the increased pulse is an attempt to
maintain adequate oxygenation of tissues, and the rapid weight loss reflects loss of
body fluid. Although impaired skin integrity is a concern with dehydration, it is not the
priority. The rapid weight loss reflects a loss of fluid, not a loss of body tissue. Although
the client may need assistance with activities, an inadequate intake of fluid has caused
the client's dehydration, which is a serious medical problem that needs to be treated
immediately.
The nurse is caring for a client 4 days after the client was admitted to the hospital with
burns on the trunk and arms. The nurse collaborates with the dietician to develop a
dietary plan for the following day. Which plan will the nurse follow? - ANSWERHigh
caloric intake, liberal potassium intake, and 3 g protein/kg/day
A high-calorie diet is needed for the increased metabolic rate associated with burns; the
administration of potassium prevents hypokalemia, which can occur after the first 48 to
72 hours when potassium moves from the extracellular compartment into the
intracellular compartment; protein promotes tissue repair. High caloric intake, restricted
potassium intake, and 1 g protein/kg/day do not meet the body's needs for tissue repair;
the protein and potassium are too limited. Moderate caloric intake, liberal potassium
intake, and 3 g protein/kg/day do not meet the body's needs for tissue repair; the
calories are too limited. Moderate caloric intake, restricted potassium intake, and 1 g
protein/kg/day do not meet the body's needs for tissue repair; the calories, potassium,
and protein are too limited.
A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client
with Cushing syndrome. Which explanation should the nurse provide to the client about
the need to follow this diet? - ANSWERExcessive aldosterone and cortisone cause
retention of sodium and loss of potassium."
Clients with Cushing syndrome must limit their intake of salt and increase their intake of
potassium. The kidneys are retaining sodium and excreting potassium. An excessive
secretion of adrenocortical hormones in Cushing syndrome, not increased or high
sodium intake, is the problem. Although sodium retention causes fluid retention and
weight gain, the need for increased potassium also must be considered. Because of
steroid therapy, excess sodium may be retained, although potassium may be excreted.
he nurse understands that research demonstrates that malnutrition occurs in as many
as 50% of hospitalized clients. The nurse should assess a postoperative client with
anorexia for what sign of malnutrition? - ANSWERDelayed wound healing
Delayed wound healing often is caused by a lack of nutrients, such as protein and
vitamin C, in the diet. Dependent edema usually occurs with severe protein deficiency
and heart failure. Spoon-shaped nails usually occur with iron deficiency anemia. Loose,
decayed teeth usually indicate prolonged malnutrition.
The nurse finds that an adolescent has episodes of binge eating followed by self-
induced vomiting and strenuous exercise. Which condition is the adolescent likely to
have? - ANSWERBulimia
, Bulimia is a disorder characterized by repeated episodes of binge eating followed by
inappropriate compensatory behavior, such as self-induced vomiting and/or strenuous
exercise. Anorexia is an eating disorder characterized by low body weight. Orthorexia is
a disorder in which the individual avoids certain foods, believing them to be harmful.
Binge behavior is consumption of large amounts of foods in a brief time but without the
subsequent compensatory behavior.
While awaiting surgery, a client with a long history of Crohn disease is receiving total
parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN
helps to prepare for surgery by which process? - ANSWERdecreasing fecal bulk
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while
the client awaits surgery. TPN does not prevent a bowel infection. TPN does not
stimulate gastrointestinal secretions. TPN promotes positive nitrogen balance.
The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF).
Which parental statement indicates the need for further education related to the
potential for poor growth? - ANSWERMy child will have a poor appetite, which will lead
to poor growth.
Pediatric clients who are diagnosed with CF experience poor growth despite a healthy
appetite and diet; therefore, the parental statement indicates that the infant's poor
appetite will lead to poor growth indicates the need for further education. Pediatric
clients diagnosed with CF experience poor growth due to delayed bone growth,
increased oxygen demands, and a decreased ability to absorb nutrients.
nurse is caring for a client with heart failure. The healthcare provider prescribes a 2-
gram sodium diet. What should the nurse include when explaining how a low-salt diet
helps achieve a therapeutic outcome? - ANSWERAllows excess tissue fluid to be
excreted
A decreased concentration of extracellular sodium causes a decrease in the release of
antidiuretic hormone (ADH); this leads to increased excretion of urine. Sodium
restriction does not control the volume of food intake; weight is controlled by a low-
calorie diet and exercise (if permitted). The resulting elimination of excess fluid reduces
the workload of the heart but does not improve contractility. Potassium is retained
inefficiently by the body; an adequate intake of potassium is needed.
The nurse assesses a client for the development of pernicious anemia after reviewing
the client's history. Which condition did the nurse most likely find in the history? -
ANSWERgastrectomy
Removal of the fundus of the stomach (gastrectomy) destroys the parietal cells that
secrete intrinsic factor (needed to combine with vitamin B12 preliminary to its absorption
in the ileum). Hemorrhaging may cause anemia; however, pernicious anemia occurs
when the intrinsic factor is not produced. The beta cells of the pancreas are not involved
in secretion of intrinsic factor. Dietary intake does not affect the production of intrinsic
factor.
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES | GRADED A+ | PROFESSOR VERIFIED
The parents of a 6-year-old child with celiac disease tell the school nurse that their child
becomes dejected because she is not able to eat snack foods like the rest of her class
and friends. What snack can the nurse recommend that is safe for the child to eat -
ANSWERtortilla chips
Products composed of corn, rice, and millet do not contain gluten and are permitted on
a low-gluten diet; tortilla chips are made from corn flour. Pretzels contain wheat flour,
which is not permitted on a low-gluten diet; products containing rye, oats, and barley are
also restricted. Oatmeal cookies contain oats, which are not permitted on a low-gluten
diet. Peanut butter crackers contain wheat flour, which is not permitted on a low-gluten
diet.
A pathology report states that a client's urinary calculus is composed of uric acid. Which
food item should the nurse instruct the client to avoid? - ANSWERliver
Uric acid stones are controlled by a low-purine diet. Foods high in purine, such as organ
meats and extracts, should be avoided. Milk should be avoided with calcium, not uric
acid, stones. Cheese or animal protein should be avoided with cystine, not uric acid,
stones. Vegetables do not have to be avoided.
The nurse is teaching a class about nutrition to a group of adolescents. Taking into
consideration the prevalence of overweight teenagers, what is the best recommendation
the nurse can make? - ANSWERdecrease fast food
Eating a variety of healthful foods instead of a fast-food diet that is high in fat and
carbohydrates helps decrease excess weight and increase energy with which to engage
in physical activities. Joining a gym is expensive and unnecessary. Physical activity can
be achieved in the schoolyard or at home. A multivitamin will not promote weight loss.
Vitamins and minerals are best obtained in a balanced diet. Diet soft drinks do not
contribute to obesity.
A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a
result of a genetic deficiency, should the nurse consider to be the cause of the client's
discomfort? - ANSWERlactase
Milk and milk products are not tolerated well because they contain lactose, a sugar that
is converted to galactose by lactase. Sucrase assists in the digestion of sucrose, which
is not a milk sugar. Maltase assists in the digestion of maltose, which is not a milk
sugar. Amylase assists in the digestion of starch, which is not a milk sugar
A client presents to the emergency department with weakness and dizziness. The blood
pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound
(1.4 kilogram) loss in two days. The weather has been hot. Which condition should the
nurse conclude is the priority for this client? - ANSWERdeficient fluid volume
,The low blood pressure indicates hypovolemia, the increased pulse is an attempt to
maintain adequate oxygenation of tissues, and the rapid weight loss reflects loss of
body fluid. Although impaired skin integrity is a concern with dehydration, it is not the
priority. The rapid weight loss reflects a loss of fluid, not a loss of body tissue. Although
the client may need assistance with activities, an inadequate intake of fluid has caused
the client's dehydration, which is a serious medical problem that needs to be treated
immediately.
The nurse is caring for a client 4 days after the client was admitted to the hospital with
burns on the trunk and arms. The nurse collaborates with the dietician to develop a
dietary plan for the following day. Which plan will the nurse follow? - ANSWERHigh
caloric intake, liberal potassium intake, and 3 g protein/kg/day
A high-calorie diet is needed for the increased metabolic rate associated with burns; the
administration of potassium prevents hypokalemia, which can occur after the first 48 to
72 hours when potassium moves from the extracellular compartment into the
intracellular compartment; protein promotes tissue repair. High caloric intake, restricted
potassium intake, and 1 g protein/kg/day do not meet the body's needs for tissue repair;
the protein and potassium are too limited. Moderate caloric intake, liberal potassium
intake, and 3 g protein/kg/day do not meet the body's needs for tissue repair; the
calories are too limited. Moderate caloric intake, restricted potassium intake, and 1 g
protein/kg/day do not meet the body's needs for tissue repair; the calories, potassium,
and protein are too limited.
A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client
with Cushing syndrome. Which explanation should the nurse provide to the client about
the need to follow this diet? - ANSWERExcessive aldosterone and cortisone cause
retention of sodium and loss of potassium."
Clients with Cushing syndrome must limit their intake of salt and increase their intake of
potassium. The kidneys are retaining sodium and excreting potassium. An excessive
secretion of adrenocortical hormones in Cushing syndrome, not increased or high
sodium intake, is the problem. Although sodium retention causes fluid retention and
weight gain, the need for increased potassium also must be considered. Because of
steroid therapy, excess sodium may be retained, although potassium may be excreted.
he nurse understands that research demonstrates that malnutrition occurs in as many
as 50% of hospitalized clients. The nurse should assess a postoperative client with
anorexia for what sign of malnutrition? - ANSWERDelayed wound healing
Delayed wound healing often is caused by a lack of nutrients, such as protein and
vitamin C, in the diet. Dependent edema usually occurs with severe protein deficiency
and heart failure. Spoon-shaped nails usually occur with iron deficiency anemia. Loose,
decayed teeth usually indicate prolonged malnutrition.
The nurse finds that an adolescent has episodes of binge eating followed by self-
induced vomiting and strenuous exercise. Which condition is the adolescent likely to
have? - ANSWERBulimia
, Bulimia is a disorder characterized by repeated episodes of binge eating followed by
inappropriate compensatory behavior, such as self-induced vomiting and/or strenuous
exercise. Anorexia is an eating disorder characterized by low body weight. Orthorexia is
a disorder in which the individual avoids certain foods, believing them to be harmful.
Binge behavior is consumption of large amounts of foods in a brief time but without the
subsequent compensatory behavior.
While awaiting surgery, a client with a long history of Crohn disease is receiving total
parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN
helps to prepare for surgery by which process? - ANSWERdecreasing fecal bulk
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while
the client awaits surgery. TPN does not prevent a bowel infection. TPN does not
stimulate gastrointestinal secretions. TPN promotes positive nitrogen balance.
The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF).
Which parental statement indicates the need for further education related to the
potential for poor growth? - ANSWERMy child will have a poor appetite, which will lead
to poor growth.
Pediatric clients who are diagnosed with CF experience poor growth despite a healthy
appetite and diet; therefore, the parental statement indicates that the infant's poor
appetite will lead to poor growth indicates the need for further education. Pediatric
clients diagnosed with CF experience poor growth due to delayed bone growth,
increased oxygen demands, and a decreased ability to absorb nutrients.
nurse is caring for a client with heart failure. The healthcare provider prescribes a 2-
gram sodium diet. What should the nurse include when explaining how a low-salt diet
helps achieve a therapeutic outcome? - ANSWERAllows excess tissue fluid to be
excreted
A decreased concentration of extracellular sodium causes a decrease in the release of
antidiuretic hormone (ADH); this leads to increased excretion of urine. Sodium
restriction does not control the volume of food intake; weight is controlled by a low-
calorie diet and exercise (if permitted). The resulting elimination of excess fluid reduces
the workload of the heart but does not improve contractility. Potassium is retained
inefficiently by the body; an adequate intake of potassium is needed.
The nurse assesses a client for the development of pernicious anemia after reviewing
the client's history. Which condition did the nurse most likely find in the history? -
ANSWERgastrectomy
Removal of the fundus of the stomach (gastrectomy) destroys the parietal cells that
secrete intrinsic factor (needed to combine with vitamin B12 preliminary to its absorption
in the ileum). Hemorrhaging may cause anemia; however, pernicious anemia occurs
when the intrinsic factor is not produced. The beta cells of the pancreas are not involved
in secretion of intrinsic factor. Dietary intake does not affect the production of intrinsic
factor.
