Nutrition – LPN Practice Questions

The following practice questions are written at NCLEX-PN level and emphasize basic diet monitoring, feeding assistance, intake and output documentation, reinforcing teaching, and knowing what to report to the registered nurse or provider. Options are numbered to match the way the list displays. Scope of practice for the licensed practical or vocational nurse varies by state and by facility policy; follow the rules in your jurisdiction.

Question 1

The LPN is assisting a client with dysphagia to eat lunch. Which action is most appropriate?

1. Position the client at a 45-degree angle in bed to reduce fatigue.
2. Position the client upright at 90 degrees and allow time between bites.
3. Offer thin liquids through a straw between each bite of food.
4. Encourage the client to tilt the head back to help food go down.

Answer: 2. Position the client upright at 90 degrees and allow time between bites.

Rationale: Sitting fully upright uses gravity to keep food moving toward the esophagus and protects the airway. Allowing time between bites prevents rushing, which is a common cause of aspiration. Option 1 is not upright enough for a client with a swallowing impairment. Option 3 is wrong on two counts: thin liquids are the easiest consistency to aspirate, and straws deliver a fast bolus to the back of the throat before the client is ready. Option 4 opens the airway and increases aspiration risk; a chin-tuck position is used instead when recommended by the speech language pathologist.

Question 2

During an 8-hour shift, a client consumes 8 ounces of coffee, 4 ounces of apple juice, 6 ounces of broth, 4 ounces of gelatin, and 300 mL of water. How many milliliters of intake should the LPN document? (1 ounce equals 30 mL.)

1. 660 mL
2. 840 mL
3. 960 mL
4. 1080 mL

Answer: 3. 960 mL.

Rationale: Convert each ounce measurement to milliliters: coffee 8 × 30 = 240 mL, juice 4 × 30 = 120 mL, broth 6 × 30 = 180 mL, and gelatin 4 × 30 = 120 mL, which totals 660 mL, plus 300 mL of water for a total of 960 mL. Gelatin and broth are counted as fluid intake because they are liquid at body temperature. The other options result from omitting the water, omitting the gelatin, or adding an item that was not consumed.

Question 3

A client has an order for a clear liquid diet. Which items may the LPN provide? Select all that apply.

1. Beef broth
2. Apple juice
3. Vanilla ice cream
4. Lemon gelatin
5. Cream of chicken soup
6. Iced tea

Answer: 1, 2, 4, and 6.

Rationale: A clear liquid diet includes fluids that are transparent and liquid at body temperature and that leave minimal residue: broth, clear juices without pulp, gelatin, plain tea and coffee, clear carbonated beverages, and popsicles without fruit pieces. Ice cream and cream soup contain milk and belong on a full liquid diet, not a clear liquid diet. The LPN should also note that a clear liquid diet is not nutritionally adequate for more than a few days and should report to the RN if a client remains on it longer than ordered.

Question 4

The LPN is assisting a client who is receiving a continuous tube feeding. Which finding should the LPN report to the registered nurse immediately?

1. The client's last bowel movement was yesterday morning.
2. The client reports the formula tastes unpleasant when burping.
3. The client begins coughing and has moist-sounding respirations.
4. The feeding pump alarm sounded once and reset after repositioning the tubing.

Answer: 3. The client begins coughing and has moist-sounding respirations.

Rationale: Coughing with wet-sounding respirations during a tube feeding suggests aspiration, which is a life-threatening airway problem. The LPN should stop the feeding, keep the head of the bed elevated, turn the client to the side, and notify the RN immediately. Option 1 is normal bowel frequency and needs only routine monitoring. Option 2 is an uncomfortable but non-urgent complaint. Option 4 describes a pump alarm that resolved with a simple mechanical fix and requires documentation and continued observation, not an urgent report.

Question 5

Which actions should the LPN take when assisting a client with meals to reduce the risk of aspiration? Select all that apply.

1. Keep the head of the bed elevated during the meal.
2. Keep the client upright for at least 30 minutes after the meal.
3. Check the client's mouth for pocketed food after each few bites.
4. Talk with the client and ask questions while the client is chewing.
5. Provide small bites and avoid rushing the meal.

Answer: 1, 2, 3, and 5.

Rationale: Upright positioning during and after meals, small bites, an unhurried pace, and checking for food pocketed in the cheeks are all core aspiration precautions. Option 4 is unsafe: asking questions while the client has food in the mouth invites the client to talk and inhale with food in the pharynx. Conversation should be limited to periods when the mouth is empty. If the client coughs, chokes, or has a wet-sounding voice during the meal, the LPN stops feeding and reports to the RN.

Question 6

The LPN is setting up a meal tray for a client who is blind. Which approach is most appropriate?

1. Cut all the food and feed the client to save time and prevent spills.
2. Describe the location of foods using the face of a clock and encourage self-feeding.
3. Place the tray on the bedside table and let the client find the items independently.
4. Mix the foods together in one bowl so the client can eat with a single spoon.

Answer: 2. Describe the location of foods using the face of a clock and encourage self-feeding.

Rationale: Orienting the client to the tray by clock position ("your chicken is at six o'clock, green beans at nine o'clock, and your milk at one o'clock") promotes independence, dignity, and adequate intake, all of which are nursing priorities. Option 1 removes independence unnecessarily when the client's limitation is vision, not motor ability. Option 3 offers no orientation and leads to spills, frustration, and poor intake. Option 4 is demeaning and eliminates the client's ability to choose what to eat.

Question 7

A client is on a 2 g sodium diet. Which lunch selection indicates that the client understands the diet?

1. Canned tomato soup with a grilled cheese sandwich
2. Baked chicken breast with fresh green beans and a baked potato
3. Ham sandwich with dill pickle spears and potato chips
4. Hot dog with sauerkraut and canned baked beans

Answer: 2. Baked chicken breast with fresh green beans and a baked potato.

Rationale: Fresh, unprocessed foods prepared without added salt are naturally low in sodium. The other options are built around the highest-sodium food categories: canned soup and processed cheese in option 1, cured meat, pickles, and salted chips in option 3, and processed meat, sauerkraut, and canned beans in option 4. The LPN can reinforce teaching that most dietary sodium comes from processed, canned, and restaurant food rather than the salt shaker, and that herbs, lemon, and salt-free seasoning blends add flavor safely. Salt substitutes should not be recommended without provider approval because they contain potassium.

Question 8

A client with type 1 diabetes who is alert and able to swallow has a capillary blood glucose of 58 mg/dL. Which action should the LPN take first?

1. Give 4 ounces of regular fruit juice.
2. Give a peanut butter sandwich and a glass of milk.
3. Notify the registered nurse and wait for further direction.
4. Recheck the glucose in 30 minutes before intervening.

Answer: 1. Give 4 ounces of regular fruit juice.

Rationale: For a conscious client who can swallow, hypoglycemia is treated with the rule of 15: give 15 g of fast-acting carbohydrate, such as 4 ounces of regular juice or regular soda, glucose tablets, or 1 tablespoon of honey, then recheck the glucose in 15 minutes and repeat if it is still below 70 mg/dL. Option 2 contains fat and protein, which slow absorption; that combination is the follow-up snack after the glucose has come up, not the initial treatment. Option 3 delays treatment for a condition that can progress to seizure and loss of consciousness; the RN is notified after the client is treated. Option 4 leaves the client hypoglycemic for a further 30 minutes.

Question 9

Which items should the LPN record on a client's intake and output record? Select all that apply.

1. Gelatin dessert
2. Urine in the collection container
3. Applesauce
4. Ice chips, recorded as half of the container volume
5. Nasogastric tube drainage
6. Emesis

Answer: 1, 2, 4, 5, and 6.

Rationale: Intake includes anything liquid at body temperature, such as gelatin, popsicles, broth, and ice chips, which are documented at approximately half the volume of the container because melted ice occupies about half the space of the chips. Output includes urine, nasogastric or other tube drainage, emesis, liquid stool, and measurable wound drainage. Applesauce is a solid food and is documented as a percentage of the meal eaten, not as fluid intake. Accurate intake and output documentation is a core LPN responsibility, and a significant imbalance should be reported to the RN.

Question 10

The LPN is obtaining a daily weight on a client with heart failure. Which action is correct?

1. Weigh the client after breakfast so the reading reflects a full day.
2. Weigh the client at the same time each morning, after voiding, in similar clothing.
3. Use whichever scale is available on the unit each day.
4. Weigh the client only when the client reports feeling swollen.

Answer: 2. Weigh the client at the same time each morning, after voiding, in similar clothing.

Rationale: Daily weight is the most accurate indicator of fluid status, and its value depends entirely on consistency of technique. The standard is the same time each day, usually before breakfast, after voiding, on the same scale, wearing the same amount of clothing. Approximately 1 kg of weight change equals about 1 liter of fluid, or roughly 2.2 pounds per liter. The LPN should report a gain of 2 to 3 pounds in 24 hours or 5 pounds in a week to the RN, because it signals fluid retention before edema and dyspnea appear. Options 1, 3, and 4 all introduce variables that make trends meaningless.

Question 11

A client's diet is advanced from clear liquid to full liquid. Which item may now be added to the tray?

1. Scrambled eggs
2. Cream of potato soup
3. Mashed potatoes
4. Buttered toast

Answer: 2. Cream of potato soup.

Rationale: A full liquid diet includes everything on the clear liquid diet plus foods that are liquid or become liquid at room temperature, including milk, milkshakes, cream soups, ice cream, pudding, custard, refined hot cereals such as strained oatmeal, and all juices including those with pulp. Scrambled eggs, mashed potatoes, and toast are solids and belong on a mechanical soft or regular diet. If a client on full liquids tolerates the tray poorly or reports nausea, the LPN reports this to the RN before the diet is advanced further.

Question 12

A client on hemodialysis is following a potassium-restricted diet and asks the LPN for a snack. Which choice is most appropriate?

1. A banana
2. A half cup of unsweetened applesauce
3. A baked potato with skin
4. A handful of dried apricots

Answer: 2. A half cup of unsweetened applesauce.

Rationale: Apples and applesauce are among the lowest-potassium fruit choices and are commonly permitted on a renal diet. Bananas, potatoes, and dried fruits such as apricots and raisins are all high in potassium, and a client who cannot excrete potassium is at risk for hyperkalemia and life-threatening dysrhythmias. Other lower-potassium options the LPN can offer include berries, grapes, canned pears or peaches with the juice drained, cabbage, green beans, and cauliflower. The LPN should reinforce that salt substitutes are potassium chloride and must be avoided.

Question 13

The LPN enters the room of a client receiving a continuous gastric tube feeding and finds the head of the bed flat because the client was repositioned for a linen change. Which action should the LPN take?

1. Continue the feeding and raise the head of the bed at the next scheduled turn.
2. Stop the feeding permanently and notify the provider.
3. Raise the head of the bed to 30 to 45 degrees and continue to monitor the client.
4. Disconnect the tube and flush it with 60 mL of cranberry juice.

Answer: 3. Raise the head of the bed to 30 to 45 degrees and continue to monitor the client.

Rationale: Elevating the head of the bed to at least 30 degrees, and preferably 30 to 45 degrees, is the single most important aspiration precaution during enteral feeding, and it should be corrected as soon as the LPN notices it. The client is then monitored for coughing, respiratory changes, and abdominal distention, and the RN is informed if any appear. Option 1 leaves the client at risk. Option 2 is outside the LPN's authority and is not indicated for a positioning issue that can simply be corrected. Option 4 is wrong because water is the flush of choice; juices and colas do not clear clogs and can worsen them, and the flush volume for routine use is about 30 mL.

Question 14

The LPN is reinforcing teaching for a client who is starting a ferrous sulfate supplement for iron deficiency anemia. Which statement by the client indicates correct understanding?

1. "I will take my iron pill with a glass of milk to protect my stomach."
2. "I will take my iron pill with a glass of orange juice."
3. "I should stop the iron if my stools turn dark."
4. "I will take my iron pill at the same time as my antacid."

Answer: 2. "I will take my iron pill with a glass of orange juice."

Rationale: Vitamin C converts iron to a form that is more readily absorbed, so taking iron with orange juice or another vitamin C source increases absorption. Options 1 and 4 are wrong because calcium in milk and the minerals in antacids bind iron and reduce absorption; iron should be separated from dairy, antacids, calcium supplements, tea, and coffee by at least 1 to 2 hours. Option 3 is wrong because dark or black stools are an expected, harmless effect of oral iron and are not a reason to stop the drug. The LPN should also reinforce increasing fluid and fiber for constipation and should report any signs of true gastrointestinal bleeding, such as bloody or tarry stools with dizziness or abdominal pain, to the RN.

Question 15

The LPN is caring for a group of clients. Which finding should be reported to the registered nurse first?

1. A client on a regular diet ate 60% of breakfast.
2. A client on a 1200 mL fluid restriction has consumed 1150 mL by 2:00 p.m.
3. A client on a low-sodium diet asks whether ketchup is allowed.
4. A client on a mechanical soft diet requests a different dessert.

Answer: 2. The client on a 1200 mL fluid restriction who has consumed 1150 mL by 2:00 p.m.

Rationale: This client has nearly reached the entire 24-hour fluid allowance with many hours and at least one meal remaining, which puts the client at risk of fluid overload, and the RN needs to know so the remaining allowance can be planned. Option 1 describes acceptable intake that is documented routinely. Option 3 is a teaching question the LPN can answer directly, since ketchup is high in sodium and should be limited, and it does not require urgent escalation. Option 4 is a preference issue handled with dietary services. The LPN's role here is to recognize which piece of data has the potential to change the client's physiologic status.

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