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NCLEX-RN Nutrition and oral hydration practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Nutrition and oral hydration sits inside the Basic Care and Comfort category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Nutrition and oral hydration sample questions

Question 1

A 48-year-old male client with a history of hypertension is admitted with hypernatremia (serum sodium 154 mEq/L) and dehydration. He is alert and oriented, with a blood pressure of 110/70 mm Hg, heart rate 98/min, and dry oral mucosa. Which nursing intervention should the nurse implement first?

  1. A Administer 0.9% sodium chloride intravenously at 100 mL/hr as prescribed.
  2. B Provide a clear liquid diet containing broth and gelatin.
  3. C Restrict all oral intake and prepare for hemodialysis.
  4. D Offer the client 120 mL of water with crushed ice every hour while awake.
Show the answer and explanation

Correct answer: D

Hypernatremia with dehydration reflects a free-water deficit. Because the client is alert and hemodynamically stable, regular oral water is the safest first way to replace free water.

Why the other options are wrong:
A: Isotonic saline does not correct a free-water deficit in a stable client and can keep the sodium high.
B: Broth is high in sodium and would worsen the hypernatremia.
C: Restricting intake worsens dehydration, and dialysis is not indicated for this sodium level.

Question 2

A 34-year-old client with Crohn's disease is admitted with an acute exacerbation, experiencing frequent watery stools and abdominal cramping. The client's serum potassium is 3.1 mEq/L, and the client reports nausea. Which dietary intervention should the nurse include in the plan of care?

  1. A Start a clear liquid diet with broth, gelatin, and oral rehydration solution to rest the bowel
  2. B Encourage a full-liquid diet including milk, cream soups, and fruit juices to maintain hydration
  3. C Offer a low-residue diet with bananas, white rice, and applesauce to reduce stool output
  4. D Provide a high-fiber diet with raw vegetables and whole grains to promote bowel regularity
Show the answer and explanation

Correct answer: A

A clear liquid diet with broth, gelatin, and oral rehydration solution rests the bowel while providing fluids and electrolytes, which is appropriate during an acute exacerbation with hypokalemia and nausea. A high-fiber diet (the option "Provide a high-fiber diet with raw vegetables and whole grains to promote bowel regularity" would increase stool bulk and worsen diarrhea and cramping. A low-residue diet (the option "Offer a low-residue diet with bananas, white rice, and applesauce to reduce stool output" is used in remission, not during an acute flare. A full-liquid diet containing milk (the option "Encourage a full-liquid diet including milk, cream soups, and fruit juices to maintain hyd..." may exacerbate diarrhea because many clients with Crohn's disease have lactose intolerance.

Question 3

A 78-year-old client in a long-term care facility has a history of dysphagia and requires thickened liquids. The nursing assistant reports that the client drank only 180 mL of thickened juice at breakfast and refused lunch. The client's current vital signs are blood pressure 108/64 mm Hg, heart rate 92 bpm, respiratory rate 18 breaths/min, and temperature 36.8 C (98.2 F). Which nursing action is most appropriate at this time?

  1. A Document the intake as acceptable and monitor the client at the next meal.
  2. B Instruct the nursing assistant to offer small sips of thin water between meals.
  3. C Assess the client's oral mucosa and offer the preferred thickened beverage.
  4. D Request a speech therapy evaluation for the client's swallowing status.
Show the answer and explanation

Correct answer: C

Only 180 mL of fluid at breakfast plus a refused lunch, with a heart rate of 92, puts this older adult at risk for dehydration. The nurse should assess hydration, starting with the oral mucosa, and encourage intake by offering a preferred thickened beverage that is safe to swallow.

Why the other options are wrong:
A: This intake is inadequate, so documenting it as acceptable ignores a developing fluid deficit.
B: Thin liquids are unsafe for a client with dysphagia who requires thickened liquids and raise aspiration risk.
D: A swallowing reevaluation may be useful later, but it does not address the client's immediate low intake.

Question 4

A 52-year-old client with chronic kidney disease stage 4 has a serum potassium of 5.6 mEq/L. Which breakfast selection indicates the client needs further teaching?

  1. A A banana, whole-grain cereal with milk, and orange juice.
  2. B Cream of wheat, a slice of white bread, and cranberry juice.
  3. C Oatmeal with blueberries, a poached egg, and coffee.
  4. D Scrambled eggs, white toast with butter, and apple juice.
Show the answer and explanation

Correct answer: A

With stage 4 kidney disease and a potassium of 5.6 mEq/L, the client must limit high-potassium foods. Bananas, orange juice, milk, and whole-grain cereal are all high in potassium, so this breakfast shows a need for more teaching.

Why the other options are wrong:
B: Cream of wheat, white bread, and cranberry juice are lower-potassium choices.
C: Oatmeal, blueberries, an egg, and coffee are moderate to low in potassium and acceptable in usual portions.
D: Eggs, white toast with butter, and apple juice are lower-potassium choices.

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