SOLUTION
Write out the information given in the question
Protein meal contains
25g of carbohydrates, 18 g of protein, and 10 g of fat.
Second meal contains
15 g of carbohydrates.
oatmeal contains
48 g of carbohydrates, 16 g of protein, and 5 g of fat.
The total of each nutrient of each meal is

From the question, amount of energy contains in each nutrient is given as

Then, we obtain the calories in each of the nutrient.
Hence
For carbohydrates, we have

Then
For Proteins, we have

For fats, we have

Hence
The total energy consume by the patient will be the sum of the energy consume from each nutirent, then

Hence
The energy consume by the patient is 623calories
The units calories(cal).