HESI Nutrition Exam

1. A client newly diagnosed with cholelithiasis is choosing an evening meal. Which food should the nurse advise the client to omit?

• A. Ketchup
• B. Ice cream
• C. Bread
• D. Beef broth

Answer: B. Cholelithiasis (gallstones) management calls for a low-fat diet, since fat intake stimulates gallbladder contraction and can trigger painful attacks; ice cream, being relatively high in fat, is the food that should be avoided among these choices.

2. An older adult client with a history of alcohol abuse is admitted with dehydration, is 20 lb under ideal weight, and has nystagmus, ataxia, and tremors. These symptoms were most likely caused by which nutritional deficiency?

• A. Protein starvation
• B. Iron deficiency anemia
• C. Lack of dietary vitamin A
• D. Vitamin B1 (Thiamine)

Answer: D. Chronic alcohol use impairs thiamine absorption and storage; the resulting deficiency classically produces the triad of nystagmus, ataxia, and confusion/tremors seen in Wernicke's encephalopathy.

3. A client has poor wound healing, easy bruising, and loose/painful teeth. Labs show normal glucose and normal Hgb/Hct. What is the most likely condition, and how should the nurse respond?

Condition: Vitamin C deficiency (scurvy). Actions: advise increased citrus fruit intake; help the client find an appropriate supplement. Monitor: wound healing and dental health.

Why: Poor wound healing, easy bruising (ecchymosis), and loose teeth/gum-related eating trouble are classic signs of scurvy, since vitamin C is essential for collagen synthesis needed for wound repair, blood vessel integrity, and periodontal health. Normal glucose and Hgb/Hct argue against hypoglycemia or iron deficiency anemia.

4. The nurse is caring for a client with chronic kidney disease advancing to stage 4. Which foods should the client limit?

• A. Apples and blueberries
• B. Cherries and cranberries
• C. Avocados and bananas

Answer: C. Avocados and bananas are both notably high in potassium, an electrolyte that must be closely restricted in advanced (stage 4) chronic kidney disease due to impaired renal potassium excretion.

5. A client with a serum sodium level of 155 mEq/L should be encouraged to choose which lunch option?

• A. Taco salad, refried beans, low-fat ice cream and coffee
• B. Bacon, lettuce, and tomato sandwich, grapes, and skim milk
• C. Canned cream of mushroom soup, tuna salad, and water
• D. Chicken salad on toast, fruit-flavored yogurt, and iced tea

Answer: D. With hypernatremia (serum sodium 155 mEq/L), the client needs a lower-sodium meal; chicken salad on toast with fruit yogurt and iced tea is comparatively the lowest-sodium option, while the other choices include high-sodium items like refried beans/taco seasoning, bacon, and canned soup.

6. I&O calculation: After reviewing 8 hours of intake and output — 8 oz orange juice, 1 cup soup, 1/2 cup apple juice, and a 12 oz soft drink consumed; 150 mL voided, 100 mL vomitus, and 250 mL voided — what is the client's net fluid balance?

Answer: +460 mL (net positive). Intake: 240 + 240 + 120 + 360 = 960 mL (solid foods don't count as fluid). Output: 150 + 100 + 250 = 500 mL. Balance: 960 − 500 = +460 mL.