22 Nutrition & Supplementation Practice Questions & Answers

1. 1. A client's one-day food record shows 250 g of carbohydrate, 110 g of protein, 70 g of fat and 14 g of alcohol. Using energy yields of 4 kcal/g for carbohydrate, 4 kcal/g for protein, 9 kcal/g for fat and 7 kcal/g for alcohol, how much energy does the day supply?

   • A.2196 kcal, because alcohol is counted at 9 kcal/g in the same way as fat
   • B.1818 kcal, because fat is counted at 4 kcal/g like the other macronutrients
   • C.2168 kcal, counting all four energy-yielding components of the record✓ Answer
   • D.2070 kcal, because alcohol is treated as a substance that yields no energy

   Each macronutrient is multiplied by its own energy yield and the products are summed: 250x4 = 1000, 110x4 = 440, 70x9 = 630 and 14x7 = 98, giving 2168 kcal. Alcohol is not a macronutrient but it does yield energy, so leaving it out understates the day.

   Source: NASM Essentials of Personal Fitness Training, nutrition chapter — energy yields of carbohydrate, protein, fat and alcoholReport a problem with this question

2. 2. A client eats 2400 kcal a day and a plan sets carbohydrate at 50% of total calories. Given that carbohydrate supplies 4 kcal/g, how many grams of carbohydrate a day does that share represent?

   • A.133 g, taking half of 2400 kcal and dividing by 9 kcal/g
   • B.600 g, dividing the full 2400 kcal by 4 kcal/g and ignoring the share
   • C.300 g, taking half of 2400 kcal and dividing by 4 kcal/g✓ Answer
   • D.1200 g, reading the carbohydrate kilocalories directly as grams

   The percentage is applied to energy first and only then converted to mass: 50% of 2400 kcal is 1200 kcal, and 1200 divided by 4 kcal/g gives 300 g. Dividing by 9 kcal/g uses the yield for fat, and skipping the percentage step doubles the answer.

   Source: NASM Essentials of Personal Fitness Training, nutrition chapter — converting a percentage of calories into grams of a macronutrientReport a problem with this question

3. 3. A client records 2000 kcal for the day, of which 80 g came from fat. Given that fat supplies 9 kcal/g, what share of the day's energy came from fat?

   • A.72%, dividing the fat kilocalories by 1000 and not the day's total
   • B.36%, because the 80 g of fat supply 720 kcal of the day's 2000✓ Answer
   • C.16%, applying 4 kcal/g to the fat instead of the correct 9 kcal/g
   • D.4%, treating the gram figure itself as a share of the calorie total

   Grams are converted to energy before any comparison: 80 g x 9 kcal/g = 720 kcal, and 720 divided by 2000 is 0.36, or 36%. Comparing grams with kilocalories directly compares two different units and cannot give a valid share.

   Source: NASM Essentials of Personal Fitness Training, nutrition chapter — expressing macronutrient intake as a percentage of total energyReport a problem with this question

4. 4. A client who eats no animal foods asks whether she can obtain all of the essential amino acids. Which statement is accurate?

   • A.Plant foods lack several essential amino acids outright, so at least one animal source is needed daily to avoid a shortfall
   • B.Eating varied plant proteins over the day — legumes, grains, nuts and seeds — covers all nine essential amino acids✓ Answer
   • C.Complementary plant proteins count only when paired in one meal, because free amino acids are not held between meals
   • D.Soy is the single plant food with a complete profile, so every meal has to be built around a soy product to be adequate

   Plant proteins are generally lower in one or two amino acids, but the amino acid that limits one food is plentiful in another, and the body draws on a circulating amino acid pool that persists for hours. A varied plant diet with enough total protein and energy therefore meets essential amino acid needs without same-meal pairing.

   Source: Academy of Nutrition and Dietetics position paper on vegetarian diets — protein quality and complementary plant proteinsReport a problem with this question

5. 5. After a demanding 90-minute conditioning session, why is a recovery meal that contains carbohydrate recommended alongside a protein source?

   • A.Carbohydrate blunts the rise in body temperature that follows hard work, so it prevents the soreness felt the following day
   • B.Carbohydrate restores the muscle and liver glycogen the session drew down, so fuel is available for the next hard session✓ Answer
   • C.Carbohydrate is the only nutrient able to rebuild the muscle protein broken down in training, so protein alone stalls repair
   • D.Carbohydrate eaten after training bypasses digestion and enters muscle cells directly, so it cannot be stored as body fat

   Glycogen stored in muscle and liver is limited and is the dominant fuel for hard continuous work, so a demanding session leaves those stores partly emptied. Carbohydrate in the recovery meal refills them, while the protein supplies amino acids for repair; the two jobs are separate.

   Source: NASM Essentials of Personal Fitness Training, nutrition chapter — carbohydrate and glycogen restoration after exerciseReport a problem with this question

6. 6. A client asks about the difference between soluble and insoluble fibre. Which description is accurate?

   • A.Soluble fibre is absorbed into the blood for energy, while insoluble fibre passes out intact and yields no usable calories
   • B.Soluble fibre adds bulk and speeds transit, while insoluble fibre forms a gel that slows digestion and the glucose rise
   • C.Soluble fibre comes only from fruit and insoluble fibre only from vegetables, so the two must be eaten at separate meals
   • D.Soluble fibre dissolves and forms a gel that slows digestion, while insoluble fibre adds bulk and speeds transit✓ Answer

   The two fractions are defined by behaviour in water: soluble fibre such as oat beta-glucan and pectin hydrates into a viscous gel that slows gastric emptying and glucose absorption, while insoluble fibre such as wheat bran and vegetable skins holds its structure, adds faecal bulk and shortens transit time. Swapping the two properties is the usual error.

   Source: NASM Essentials of Personal Fitness Training, nutrition chapter — soluble and insoluble dietary fibreReport a problem with this question

7. 7. Which fatty acids must be supplied by the diet because the body cannot synthesise them?

   • A.Linoleic acid, an omega-6 fatty acid, and alpha-linolenic acid, an omega-3 fatty acid✓ Answer
   • B.Elaidic acid, an industrial trans fatty acid, and lauric acid, a saturated one
   • C.Oleic acid, a monounsaturated fatty acid, and palmitic acid, a saturated fatty acid
   • D.Stearic acid, a long-chain saturated fatty acid, and butyric acid, a short-chain one

   Human enzymes cannot insert a double bond beyond the ninth carbon from the methyl end, so the omega-6 and omega-3 parent fatty acids have to come from food. Every other fatty acid listed, saturated or monounsaturated, can be made in the body from other substrates.

   Source: NIH Office of Dietary Supplements fact sheet on omega-3 fatty acids — linoleic and alpha-linolenic acid as the essential fatty acidsReport a problem with this question

8. 8. Using the conventional estimate that 3500 kcal is about one pound of body fat, how much loss would a sustained deficit of 500 kcal a day predict over four weeks?

   • A.About 7 lb, because the deficit is counted at 2000 kcal per pound
   • B.About 14 lb, because each 1000 kcal of deficit is counted as a pound
   • C.About 2 lb, because only the 14 training days of the month are counted
   • D.About 4 lb, because the four-week deficit adds up to 14000 kcal✓ Answer

   Four weeks is 28 days, so 500 kcal x 28 = 14000 kcal of accumulated deficit, and 14000 divided by 3500 kcal per pound predicts about 4 lb. The estimate is a planning rule of thumb rather than a guarantee, because expenditure drifts downward as body mass falls.

   Source: NASM Essentials of Personal Fitness Training, weight-management section — the conventional 3500 kcal per pound planning estimateReport a problem with this question

9. 9. A client has eaten far below her needs for several months and her strength gains have stopped. What does prolonged severe energy restriction typically do?

   • A.Costs lean tissue and lowers daily energy expenditure, so training quality and recovery fall and progress stalls✓ Answer
   • B.Leaves expenditure physiologically untouched, so a stall can only mean she is under-reporting what she actually eats
   • C.Raises resting metabolic rate as the body works harder to conserve tissue, so loss keeps accelerating with no plateau
   • D.Shifts the body to burning fat only, so lean tissue is spared and strength keeps climbing on the lower intake

   When energy availability stays very low, the body draws on protein as well as fat and reduces resting and non-exercise expenditure, a response usually called metabolic adaptation. Less lean tissue and poorer recovery mean training quality drops, which is why strength plateaus despite the large deficit.

   Source: NASM Essentials of Personal Fitness Training, weight-management section — risks of severe energy restriction and metabolic adaptationReport a problem with this question

10. 10. During a hot outdoor session a client loses fluid equal to about 3% of his body mass. Taking the commonly cited threshold that losses of 2% or more begin to impair performance, what is the practical consequence?

    • A.Only cognitive function is affected at this level, since strength and power depend on glycogen rather than fluid
    • B.The loss is entirely stored body fat, so it confirms the session worked and no fluid replacement is needed
    • C.Endurance, strength and heat regulation are measurably impaired and heart rate rises at the same workload✓ Answer
    • D.Performance holds up until thirst becomes strong, because thirst is the body's early and reliable fluid warning

    Losing body water reduces plasma volume, so stroke volume falls and heart rate must rise to hold cardiac output, while skin blood flow for heat dissipation competes with muscle for that smaller volume. Past the stated 2% mark these effects are large enough to show up as reduced endurance, strength and thermoregulation, and thirst lags behind the loss rather than preceding it.

    Source: National Athletic Trainers' Association position statement on fluid replacement for the physically active — performance decrement with body-mass lossReport a problem with this question

11. 11. A client finishing a long endurance event drank large volumes of plain water throughout and is now confused, nauseated and headachy, with no weight lost on the scale. What is the likely explanation and the right response?

    • A.Blood sodium diluted by excess plain water; stop the plain water and get medical help rather than pushing more fluid✓ Answer
    • B.Low blood glucose after the long event; give a large plain-water bolus with a sugar-free electrolyte tablet in it
    • C.Heat cramps from potassium loss; stretch the affected muscles and let him keep drinking plain water as he wishes
    • D.Straightforward dehydration from sweat loss; hand him more plain water and let him carry on once the headache eases

    Drinking plain water far in excess of sweat losses dilutes plasma sodium, and water then moves into cells, including brain cells, which produces the confusion, nausea and headache. The absence of weight loss is the giveaway that this is dilution rather than dehydration, and giving more plain water makes it worse, so the event is a medical emergency.

    Source: National Athletic Trainers' Association position statement on fluid replacement for the physically active — exercise-associated hyponatremiaReport a problem with this question

12. 12. Midway through an outdoor session on a hot day a client becomes confused, stops sweating normally, and has hot, flushed skin. What should the trainer do FIRST?

    • A.Give him salt tablets and a large volume of cold plain water, then resume once his skin colour looks normal
    • B.Stop the session, move him to shade, activate emergency medical services and begin cooling him straight away✓ Answer
    • C.Take him indoors and have him lie down alone for twenty minutes before deciding whether help is needed
    • D.Let him finish the remaining sets at a lighter load while sipping a sports drink, then check how he feels

    Confusion or any other change in mental status together with hot skin points to exertional heat stroke, in which the danger is the length of time core temperature stays elevated. Emergency services and immediate cooling are therefore the first actions; continuing to exercise, self-treating with salt and water, or leaving the client unattended all delay the only treatment that changes the outcome.

    Source: National Athletic Trainers' Association position statement on exertional heat illnesses — recognition and immediate management of exertional heat strokeReport a problem with this question

13. 13. A client is taking high doses of a single-vitamin supplement and asks whether that carries any risk. Which principle applies?

    • A.Only minerals such as iron and zinc reach harmful levels, since vitamins are organic and are broken down completely
    • B.Water-soluble vitamins are the group stored in body fat and liver, so they are the ones that accumulate at high doses
    • C.Vitamins carry no risk at any dose, because the body excretes whatever it does not need on the day it is swallowed
    • D.Fat-soluble vitamins A, D, E and K are stored in body fat and liver, so chronic high doses can build to harmful levels✓ Answer

    Solubility governs what happens to a surplus: fat-soluble vitamins partition into adipose tissue and liver and are cleared slowly, so repeated high doses accumulate, whereas most water-soluble vitamins are filtered by the kidney and lost in urine. That difference is why single-nutrient megadoses of A or D in particular are the ones associated with toxicity.

    Source: NIH Office of Dietary Supplements fact sheets on vitamin A and vitamin D — storage of fat-soluble vitamins and risk of excessive intakeReport a problem with this question

14. 14. Which statement correctly describes the main role of iron in the body?

    • A.Iron supplies energy directly at four kilocalories per gram, so a shortfall shows as an immediate drop in fuel
    • B.Iron is the main mineral of bone tissue and gives the skeleton rigidity, so a shortfall shows as stress fractures
    • C.Iron sits in haemoglobin and carries oxygen in the blood, so a shortfall shows as fatigue and poorer endurance✓ Answer
    • D.Iron is the chief electrolyte governing fluid balance and nerve signals, so a shortfall shows as muscle cramping

    Iron is the atom at the centre of the haem group that binds oxygen in haemoglobin and myoglobin, so an iron shortfall limits oxygen delivery to working muscle before it produces anything else. That is why the first signs are tiredness and a fall in endurance capacity, and why menstruating and endurance-training clients are watched for it.

    Source: NIH Office of Dietary Supplements fact sheet on iron — iron in haemoglobin and oxygen transportReport a problem with this question

15. 15. A client points out that a fat-burner is sold in a major retail chain and asks whether that means it is proven safe and effective. How are dietary supplements regulated in the United States?

    • A.Regulated as food, not as drugs, with no pre-market proof of safety or effectiveness and the maker carrying that duty✓ Answer
    • B.Exempt from all federal oversight, so no agency has authority to act even once a product is shown to cause harm
    • C.Cleared by an independent federal laboratory that verifies the labelled dose of each batch before it may be shipped
    • D.Reviewed as over-the-counter drugs, so each product is tested for safety and effectiveness before it is sold

    Under the federal supplement statute these products sit in the food category, so a manufacturer may market one without submitting evidence of safety or efficacy for approval, and the regulator must build a case after the fact to remove a product. Wide retail distribution therefore reflects commercial supply, not any government finding about the product.

    Source: U.S. Dietary Supplement Health and Education Act, as implemented in FDA regulation of dietary supplements as a category of foodReport a problem with this question

16. 16. A client asks what a third-party sport certification seal on a supplement tub actually tells him. What does such a seal indicate?

    • A.The ingredients were proven effective in clinical trials, because certification testing includes work on efficacy
    • B.The product is safe for anyone at any dose, because certification also covers interactions with prescription drugs
    • C.The product was tested so its contents match the label and it is free of the banned substances screened for✓ Answer
    • D.A government agency approved the product's health claims and confirmed it performs the way the marketing states

    Sport certification programmes test identity, quantity and contamination: they verify that what is in the tub matches the panel and screen against a list of substances banned in sport. They make no judgement about whether the ingredient works, whether the dose suits a given person, or how it interacts with medication.

    Source: FDA dietary supplement labeling guidance and the published scope of sport certification programmes such as NSF Certified for Sport and Informed SportReport a problem with this question

17. 17. A client asks his trainer to write a seven-day meal plan with set foods and portions for his fat-loss goal. What is the appropriate course of action?

    • A.Build the plan from published dietary guidance, since that rests on public information and not clinical judgement
    • B.Write the plan and have him sign a waiver stating the trainer is not a dietitian, which shifts responsibility to him
    • C.Refer the individualised plan to a registered dietitian and keep coaching general portion estimation and label reading✓ Answer
    • D.Set the plan's calories below his estimated needs and review it weekly, adjusting foods as his weight changes

    Prescribing specific foods and portions for one person is individualised nutrition care, which belongs to the dietetics professional, and a signed waiver does not create authority a trainer never held. The trainer keeps a real and useful role: general education on portions, labels and eating patterns, plus the behaviour coaching that drives adherence.

    Source: NASM Essentials of Personal Fitness Training, professional practice section on nutrition scope; Academy of Nutrition and Dietetics scope of practice for the registered dietitian nutritionistReport a problem with this question

18. 18. A trainer has earned a separate nutrition-coaching certificate and works in a state that licenses dietetics practice. What does that certificate change?

    • A.It qualifies him to issue individualised nutrition prescriptions, because a recognised credential satisfies the state rule
    • B.It broadens his general education while state licensure law still decides who may give individualised nutrition advice✓ Answer
    • C.It lets him use the title nutritionist in his marketing, because the certificate comes from a nationally known body
    • D.It permits him to manage a client's diabetes through diet provided the client's physician is told about the plan afterwards

    Certificates are issued by private organisations, while the right to practise dietetics is granted by the state through licensure, and only the state can widen it. Extra study makes the trainer better at the general education he is already allowed to give, but the legal boundary around individualised advice and disease management stays exactly where the statute puts it.

    Source: State dietetics licensure statutes and the NASM code of professional conduct on practising within one's scopeReport a problem with this question

19. 19. A client wants a swap that raises nutrient density while lowering energy density. Which change does that?

    • A.Swapping olive oil for butter on cooked vegetables, which keeps calories level while adding fat-soluble vitamins
    • B.Swapping a bowl of vegetable soup for a granola bar, which packs more calories into a smaller format
    • C.Swapping whole fruit for a fruit-flavoured juice drink, which delivers the same sugars in a faster-absorbed form
    • D.Swapping buttered crackers for a bowl of mixed vegetables and beans, which supplies more micronutrients per calorie✓ Answer

    Nutrient density compares vitamins, minerals and fibre against the calories delivered, while energy density is calories per gram of food. Vegetables and beans are mostly water and fibre, so a large satisfying volume arrives with few calories and plenty of micronutrients, whereas the other swaps add calories, remove fibre, or leave both measures where they were.

    Source: NASM Essentials of Personal Fitness Training, nutrition chapter — nutrient density compared with energy densityReport a problem with this question

20. 20. A client has taken a high-dose vitamin B6 supplement for months and reports tingling and numbness in his hands and feet. Which statement fits this situation?

    • A.Vitamin B6 turns fat-soluble at high doses and is stored in the liver, so the symptoms clear once he trains the store off
    • B.Vitamin B6 is water-soluble yet damages nerves at chronic high doses, so he should stop it and see his physician✓ Answer
    • C.Vitamin B6 in excess only irritates the stomach lining, so the tingling points to dehydration and resolves with fluid
    • D.Vitamin B6 is water-soluble and any excess is excreted, so the symptoms must come from a shortfall of another B vitamin

    Vitamin B6 is the standard exception to the assumption that water-soluble vitamins are harmless in excess: sustained high intakes are linked to sensory neuropathy, which presents exactly as tingling and numbness in the hands and feet. Because this is a possible adverse effect of a supplement, the client is referred to a physician rather than advised by the trainer.

    Source: NIH Office of Dietary Supplements fact sheet on vitamin B6 — sensory neuropathy associated with chronic high intakesReport a problem with this question

21. 21. A client mentions skipping meals for days, training secretly on top of her sessions, and losing her period, and she asks the trainer to cut her calories further. What should the trainer do?

    • A.Hand her a printed eating-disorder screening questionnaire, score it, and shape the next training block on the result
    • B.Voice concern, hold her intake where it is, and refer her to a physician and a licensed mental health professional✓ Answer
    • C.Set a lower calorie target with a scheduled refeed day and track her weekly weight to keep the loss within a safe rate
    • D.Leave the calories where they are, add two extra conditioning sessions a week, and revisit the whole plan in a month

    Food restriction, hidden compulsive exercise and loss of menstrual function together describe low energy availability with disordered eating, a medical and psychological picture rather than a programming problem. Screening and diagnosis are outside a trainer's remit, and cutting intake further would deepen the very deficit causing the harm, so referral is the action that protects the client.

    Source: NASM code of professional conduct on referral for suspected disordered eating; international consensus statements on relative energy deficiency in sportReport a problem with this question

22. 22. A healthy adult client asks what creatine monohydrate does and whether the early weight gain is fat. Within a trainer's scope, which general information is accurate?

    • A.It damages the kidneys of healthy adults at any dose, and the early weight gain is fluid retained by the strained kidneys
    • B.It is a mild anabolic steroid, and the early weight gain is the hormonal shift the compound produces in healthy adults
    • C.It works mainly by extending endurance in long steady events, and the early weight gain is newly added body fat
    • D.It supports repeated short bursts of high-intensity work, and the early weight gain is water drawn into muscle cells✓ Answer

    Creatine raises the muscle store of phosphocreatine, which regenerates ATP during efforts of a few seconds, so the benefit shows in repeated sprints and heavy sets rather than in steady endurance. Creatine is an amino acid derivative and not a hormone, and it is osmotically active, which is why the first pounds gained are intracellular water.

    Source: NIH Office of Dietary Supplements fact sheet on dietary supplements for exercise and athletic performance — creatineReport a problem with this question

Practice questions written to the published exam content outline for the NASM Certified Personal Trainer credential and to the standard exercise-science material common to accredited personal-training certifications. NASM and OPT are marks of the National Academy of Sports Medicine; this site is not affiliated with or endorsed by NASM, ACE, ISSA, or NSCA. Exam content outlines are revised periodically — confirm current requirements with your certifying body before testing. Nothing here is medical advice; a personal trainer does not diagnose, treat, or prescribe. About the CPT certification →