Question 1

Approximately 5 days after starting tube feedings,a patient develops extreme diarrhea.A stool specimen is collected to check for which possible cause?

Accepted Answer

A)  Clostridium difficile 
B)  Escherichia coli 
C)  Occult blood 
D)  Ova and parasites 
A)  Clostridium difficile 
B)  Escherichia coli 
C)  Occult blood 
D)  Ova and parasites A

Question 2

A patient is having complications from abdominal surgery and remains NPO.Because enteral tube feedings are not possible,the decision is to initiate parenteral feedings.What are the major complications for this therapy?

Accepted Answer

A)  Aspiration pneumonia and sepsis 
B)  Sepsis and fluid and electrolyte imbalances 
C)  Fluid overload and pulmonary edema 
D)  Hypoglycemia and renal insufficiency 
A)  Aspiration pneumonia and sepsis 
B)  Sepsis and fluid and electrolyte imbalances 
C)  Fluid overload and pulmonary edema 
D)  Hypoglycemia and renal insufficiency B

Question 3

In addition to residual stomach volume,what other evidence suggests feeding intolerance?

Accepted Answer

A)  Abdominal distension 
B)  Absence of tympany on percussion 
C)  Active bowel sounds 
D)  Elevated blood glucose by fingerstick 
A)  Abdominal distension 
B)  Absence of tympany on percussion 
C)  Active bowel sounds 
D)  Elevated blood glucose by fingerstick A

Question 4

The nurse identifies which patient at greatest risk for malabsorption of protein?

Accepted Answer

A)  The patient with gallbladder obstruction 
B)  The patient with ileitis 
C)  The patient with distal colon resection 
D)  The patient with jejunal tumor 
A)  The patient with gallbladder obstruction 
B)  The patient with ileitis 
C)  The patient with distal colon resection 
D)  The patient with jejunal tumor

Question 5

Which of the following statements is true about insulin and parenteral nutrition? (Select all that apply.)

Accepted Answer

A)  The amount of parenteral insulin is adjusted based on the previous 24-hour laboratory values. 
B)  Insulin may be added to a parenteral nutrition solution. 
C)  Subcutaneous insulin is used on a sliding scale during parenteral nutrition. 
D)  Supplemental insulin is rarely required for patients receiving parenteral nutrition. 
E)  Lingering hyperglycemia after parenteral nutrition has stopped requires continuing insulin. 
A)  The amount of parenteral insulin is adjusted based on the previous 24-hour laboratory values. 
B)  Insulin may be added to a parenteral nutrition solution. 
C)  Subcutaneous insulin is used on a sliding scale during parenteral nutrition. 
D)  Supplemental insulin is rarely required for patients receiving parenteral nutrition. 
E)  Lingering hyperglycemia after parenteral nutrition has stopped requires continuing insulin.

Question 6

Objective data designating that the nutrition goals are not being met include

Accepted Answer

A)  hyperglycemia, normovolemia, and increased protein level. 
B)  overhydration, hypoglycemia, and weight gain. 
C)  weight gain, inconsistent glucose, and normovolemia. 
D)  weight loss, elevated glucose, and dehydration. 
A)  hyperglycemia, normovolemia, and increased protein level. 
B)  overhydration, hypoglycemia, and weight gain. 
C)  weight gain, inconsistent glucose, and normovolemia. 
D)  weight loss, elevated glucose, and dehydration.

Question 7

Which statement is true about normal function of the gastrointestinal (GI)tract?

Accepted Answer

A)  Failure of the tight junctions allows bacteria to invade the GI tract. 
B)  The gut lacks protective mechanisms; thus, infection is always a concern. 
C)  Water is reabsorbed at the beginning of the colon. 
D)  Without nutritional stimulation, mucosal villi atrophy. 
A)  Failure of the tight junctions allows bacteria to invade the GI tract. 
B)  The gut lacks protective mechanisms; thus, infection is always a concern. 
C)  Water is reabsorbed at the beginning of the colon. 
D)  Without nutritional stimulation, mucosal villi atrophy.

Question 8

In evaluating a patient's nutrition,the nurse would monitor which blood test as the most sensitive indicator of protein synthesis and catabolism?

Accepted Answer

A)  Albumin 
B)  BUN 
C)  Prealbumin 
D)  Triglycerides 
A)  Albumin 
B)  BUN 
C)  Prealbumin 
D)  Triglycerides

Question 9

A patient is receiving enteral feedings and reports fullness and abdominal discomfort.What action by the nurse is best?

Accepted Answer

A)  Connect the feeding tube to suction. 
B)  Continue the tube feeding. 
C)  Decrease the tube feeding. 
D)  Assess the patient's gastric residual. 
A)  Connect the feeding tube to suction. 
B)  Continue the tube feeding. 
C)  Decrease the tube feeding. 
D)  Assess the patient's gastric residual.

Question 10

Which statements about total parenteral nutrition are correct? (Select all that apply.)

Accepted Answer

A)  assessing fluid volume status and preventing infection are important nursing considerations. 
B)  fingerstick glucose levels are assessed every 6 hours and prn. 
C)  total parenteral nutrition is administered through a feeding tube and pump. 
D)  total parenteral nutrition with added lipids provides adequate levels of protein, carbohydrates, and fats. 
E)  soy-based lipids should not be given during the first week of a critical illness. 
A)  assessing fluid volume status and preventing infection are important nursing considerations. 
B)  fingerstick glucose levels are assessed every 6 hours and prn. 
C)  total parenteral nutrition is administered through a feeding tube and pump. 
D)  total parenteral nutrition with added lipids provides adequate levels of protein, carbohydrates, and fats. 
E)  soy-based lipids should not be given during the first week of a critical illness.

Question 11

A patient with a history of emphysema,diabetes,and hyperlipidemia is in the critical care unit on a ventilator.The nutrition assessment notes that the patient has a protein and vitamin deficiency and is underweight.Which formula for nutritional assessment is most appropriate?

Accepted Answer

A)  Elemental protein formula 
B)  Fiber-added formula 
C)  High medium-chain triglyceride formula 
D)  Lactose-free formula 
A)  Elemental protein formula 
B)  Fiber-added formula 
C)  High medium-chain triglyceride formula 
D)  Lactose-free formula

Question 12

A patient is being ventilated and has been started on enteral feedings with a nasogastric small-bore feeding tube.What is the primary reason the nurse must frequently assess tube placement?

Accepted Answer

A)  To assess for paralytic ileus 
B)  To maintain the patency of the feeding tube 
C)  To monitor for skin breakdown on the nose 
D)  To prevent aspiration of the feedings 
A)  To assess for paralytic ileus 
B)  To maintain the patency of the feeding tube 
C)  To monitor for skin breakdown on the nose 
D)  To prevent aspiration of the feedings

Question 13

Which interventions are critical during intravenous lipid administration? (Select all that apply.)

Accepted Answer

A)  Assess glucose levels every 6 hours. 
B)  Change the tubing every 24 hours. 
C)  Hold lipids when administering antibiotics through the same line. 
D)  Monitor triglyceride levels periodically. 
E)  Maintain elevation of the head of the bed. 
A)  Assess glucose levels every 6 hours. 
B)  Change the tubing every 24 hours. 
C)  Hold lipids when administering antibiotics through the same line. 
D)  Monitor triglyceride levels periodically. 
E)  Maintain elevation of the head of the bed.

Question 14

Patients experiencing severe physiological stress increase their nutritional requirements to:

Accepted Answer

A)  20 kcal/kg/day. 
B)  30 kcal/kg/day. 
C)  35 kcal/kg/day. 
D)  50 kcal/kg/day. 
A)  20 kcal/kg/day. 
B)  30 kcal/kg/day. 
C)  35 kcal/kg/day. 
D)  50 kcal/kg/day.

Question 15

A patient with severe burns had a dietitian consultation for nutritional support.The patient weighs 145 pounds.What recommendations by the dietitian does the nurse anticipate initiating? (Select all that apply.)

Accepted Answer

A)  At least 2307 kcal/day 
B)  Juven formula 
C)  2 cal HN formula 
D)  At least 1648 kcal/day 
E)  Perative formula 
A)  At least 2307 kcal/day 
B)  Juven formula 
C)  2 cal HN formula 
D)  At least 1648 kcal/day 
E)  Perative formula

Question 16

A patient who is receiving continuous enteral feedings has just vomited 250 mL of milky green fluid.What action by the nurse takes priority?

Accepted Answer

A)  Notify the provider. 
B)  Assess the patient's lungs and oxygen saturation. 
C)  Stop the tube feeding. 
D)  Slow the rate of the infusion. 
A)  Notify the provider. 
B)  Assess the patient's lungs and oxygen saturation. 
C)  Stop the tube feeding. 
D)  Slow the rate of the infusion.

Question 17

A critically ill patient has a nonhealing wound and malnutrition.Which component of nutritional supplementation is most important for this patient to receive?

Accepted Answer

A)  Arginine 
B)  Omega-3 fatty acids 
C)  Branched-chain amino acids 
D)  Vitamin A 
A)  Arginine 
B)  Omega-3 fatty acids 
C)  Branched-chain amino acids 
D)  Vitamin A

Question 18

Malnutrition contributes to infection risk by

Accepted Answer

A)  hampering normal gastrointestinal motility. 
B)  impairing immune function. 
C)  increasing blood glucose. 
D)  increasing drug interactions. 
A)  hampering normal gastrointestinal motility. 
B)  impairing immune function. 
C)  increasing blood glucose. 
D)  increasing drug interactions.

Question 19

An important nutritional consideration in the elderly population is

Accepted Answer

A)  a decrease in protein requirements. 
B)  an increase in caloric requirements with age. 
C)  the potential for drug-nutrient interaction related to polypharmacy. 
D)  the presence of other diseases that decrease caloric needs. 
A)  a decrease in protein requirements. 
B)  an increase in caloric requirements with age. 
C)  the potential for drug-nutrient interaction related to polypharmacy. 
D)  the presence of other diseases that decrease caloric needs.

Question 20

The patient is to start parenteral nutrition.The nurse knows to prepare which site for catheter insertion?

Accepted Answer

A)  Basilic vein 
B)  Femoral vein 
C)  Radial artery 
D)  Subclavian vein 
A)  Basilic vein 
B)  Femoral vein 
C)  Radial artery 
D)  Subclavian vein

Exam 6: Nutritional Support

Approximately 5 days after starting tube feedings,a patient develops extreme diarrhea.A stool specimen is collected to check for which possible cause?

A patient is having complications from abdominal surgery and remains NPO.Because enteral tube feedings are not possible,the decision is to initiate parenteral feedings.What are the major complications for this therapy?

In addition to residual stomach volume,what other evidence suggests feeding intolerance?

The nurse identifies which patient at greatest risk for malabsorption of protein?

Which of the following statements is true about insulin and parenteral nutrition? (Select all that apply.)

Objective data designating that the nutrition goals are not being met include

Which statement is true about normal function of the gastrointestinal (GI)tract?

In evaluating a patient's nutrition,the nurse would monitor which blood test as the most sensitive indicator of protein synthesis and catabolism?

A patient is receiving enteral feedings and reports fullness and abdominal discomfort.What action by the nurse is best?

Which statements about total parenteral nutrition are correct? (Select all that apply.)

A patient with a history of emphysema,diabetes,and hyperlipidemia is in the critical care unit on a ventilator.The nutrition assessment notes that the patient has a protein and vitamin deficiency and is underweight.Which formula for nutritional assessment is most appropriate?

A patient is being ventilated and has been started on enteral feedings with a nasogastric small-bore feeding tube.What is the primary reason the nurse must frequently assess tube placement?

Which interventions are critical during intravenous lipid administration? (Select all that apply.)

Patients experiencing severe physiological stress increase their nutritional requirements to:

A patient with severe burns had a dietitian consultation for nutritional support.The patient weighs 145 pounds.What recommendations by the dietitian does the nurse anticipate initiating? (Select all that apply.)

A patient who is receiving continuous enteral feedings has just vomited 250 mL of milky green fluid.What action by the nurse takes priority?

A critically ill patient has a nonhealing wound and malnutrition.Which component of nutritional supplementation is most important for this patient to receive?

Malnutrition contributes to infection risk by

An important nutritional consideration in the elderly population is

The patient is to start parenteral nutrition.The nurse knows to prepare which site for catheter insertion?

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

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