Question 1

Describe the current procedure for administering a central TPN feeding.

Accepted Answer

The current procedure for administering

Question 2

Mrs.Winslow is receiving TPN.Today's lab work shows that her triglyceride level is 500 mg/dL.The nurse recognizes that:

Accepted Answer

A) the TPN should be stopped immediately. 
B) the dextrose concentration of the TPN solution should be decreased. 
C) the rate of the TPN should be decreased. 
D) the infusion of lipids should be reduced or stopped. 
A) the TPN should be stopped immediately. 
B) the dextrose concentration of the TPN solution should be decreased. 
C) the rate of the TPN should be decreased. 
D) the infusion of lipids should be reduced or stopped.

Question 3

Dextrose monohydrate provides _____ kcal/g.

Accepted Answer

A) 0.9 
B) 1.8 
C) 2.5 
D) 3.4 
A) 0.9 
B) 1.8 
C) 2.5 
D) 3.4

Question 4

Mr.White is feeling anxious about being on a tube feeding.The nurse can help alleviate his fears by all of the following except:

Accepted Answer

A) allowing him to see and touch the feeding tube. 
B) allowing him to taste the enteral product. 
C) explaining how the tube feeding will work. 
D) assuring him that he can still swallow foods and beverages with the tube in place. 
A) allowing him to see and touch the feeding tube. 
B) allowing him to taste the enteral product. 
C) explaining how the tube feeding will work. 
D) assuring him that he can still swallow foods and beverages with the tube in place.

Question 5

All of the following are characteristics of elemental formulas except:

Accepted Answer

A) they contain broken-down molecules of protein. 
B) they require only minimal digestion. 
C) they are used for clients who have a smaller than normal area for absorbing nutrients. 
D) they are given to clients who are able to digest and absorb nutrients without difficulty. 
A) they contain broken-down molecules of protein. 
B) they require only minimal digestion. 
C) they are used for clients who have a smaller than normal area for absorbing nutrients. 
D) they are given to clients who are able to digest and absorb nutrients without difficulty.

Question 6

Fiber in an enteral formula provides all of the following benefits except:

Accepted Answer

A) it normalizes intestinal function. 
B) it helps to treat diarrhea and constipation. 
C) it increases the caloric content of the formula. 
D) it helps with blood glucose control. 
A) it normalizes intestinal function. 
B) it helps to treat diarrhea and constipation. 
C) it increases the caloric content of the formula. 
D) it helps with blood glucose control.

Question 7

A drawback to using specialized or disease-specific formulas is:

Accepted Answer

A) they are expensive. 
B) patients do not tolerate them well. 
C) they cause high gastric residuals. 
D) they are not available for common chronic conditions. 
A) they are expensive. 
B) patients do not tolerate them well. 
C) they cause high gastric residuals. 
D) they are not available for common chronic conditions.

Question 8

A parenteral solution that contains dextrose, amino acids, and lipids is called a:

Accepted Answer

A) standard formula. 
B) modular formula. 
C) 2-in-1 solution. 
D) total nutrient admixture. 
A) standard formula. 
B) modular formula. 
C) 2-in-1 solution. 
D) total nutrient admixture.

Question 9

Mr.Edward's blood glucose level rises to 350 mg/dL.What will the health care team likely do about this?

Accepted Answer

A) nothing; this is acceptable for a patient receiving TPN 
B) taper off his lipids infusion 
C) stop his TPN infusion entirely 
D) infuse insulin with his TPN 
A) nothing; this is acceptable for a patient receiving TPN 
B) taper off his lipids infusion 
C) stop his TPN infusion entirely 
D) infuse insulin with his TPN

Question 10

Dietary treatment of galactosemia depends primarily on the elimination of:

Accepted Answer

A) chicken and fish. 
B) milk and milk products. 
C) fruits and vegetables. 
D) cereals and pasta. 
A) chicken and fish. 
B) milk and milk products. 
C) fruits and vegetables. 
D) cereals and pasta.

Question 11

A formula that approximates the osmolality of normal blood serum:

Accepted Answer

A) is called a hypertonic formula. 
B) is referred to as an isotonic formula. 
C) has an osmolality of approximately 500 milliosmoles per liter. 
D) is usually a hydrolyzed formula. 
A) is called a hypertonic formula. 
B) is referred to as an isotonic formula. 
C) has an osmolality of approximately 500 milliosmoles per liter. 
D) is usually a hydrolyzed formula.

Question 12

The nurse understands that infusing medications along with an enteral formula increases the osmolality of the tube feeding and may cause a patient to experience:

Accepted Answer

A) diarrhea. 
B) elevated blood glucose levels. 
C) high blood pressure. 
D) constipation. 
A) diarrhea. 
B) elevated blood glucose levels. 
C) high blood pressure. 
D) constipation.

Question 13

The nurse recognizes all of the following as advantages of enteral nutrition over parenteral nutrition except:

Accepted Answer

A) it is less likely to cause gallbladder or liver disease. 
B) it causes fewer complications. 
C) it is better accepted by clients psychologically and physically. 
D) it costs less than feeding by vein. 
A) it is less likely to cause gallbladder or liver disease. 
B) it causes fewer complications. 
C) it is better accepted by clients psychologically and physically. 
D) it costs less than feeding by vein.

Question 14

Mr.Avery's swallowing ability and oral intake are improving.He is now consuming about 2/3 of his estimated nutrient needs from oral intake.It would be appropriate at this time to:

Accepted Answer

A) discontinue the tube feeding. 
B) increase the rate of the tube feeding. 
C) decrease the rate of the parenteral feeding. 
D) discontinue the parenteral feeding.
Use the following case study to answer questions 63-68.
Mr)Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center upon being found unconscious in his car in a parking lot and resuscitated.His history was obtained by contacting his daughter.The patient presents with:
$\bullet$end-stage adenocarcinoma of the gastroestophageal juncture.
$\bullet$chronic malnutrition and significant weight loss × 1 year.Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
$\bullet$acute pancreatitis with intractable vomiting.
Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery.Meds: antilipemic medication, antihypertensive medication.
Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s.
Ht: 5'8".Admission Wt: 107 lbs.Usual Wt, 1 year ago: 170 lbs.
Social Hx: Lives alone; cooks and shops for himself despite illness.
Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet.
Mr)Edward is not being actively treated for cancer at his request.Plan is to keep Mr.Edward NPO and place a peripheral line for hydration and nutrition support. 
A) discontinue the tube feeding. 
B) increase the rate of the tube feeding. 
C) decrease the rate of the parenteral feeding. 
D) discontinue the parenteral feeding.
Use the following case study to answer questions 63-68.
Mr)Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center upon being found unconscious in his car in a parking lot and resuscitated.His history was obtained by contacting his daughter.The patient presents with:
$\bullet$end-stage adenocarcinoma of the gastroestophageal juncture.
$\bullet$chronic malnutrition and significant weight loss × 1 year.Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
$\bullet$acute pancreatitis with intractable vomiting.
Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery.Meds: antilipemic medication, antihypertensive medication.
Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s.
Ht: 5'8".Admission Wt: 107 lbs.Usual Wt, 1 year ago: 170 lbs.
Social Hx: Lives alone; cooks and shops for himself despite illness.
Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet.
Mr)Edward is not being actively treated for cancer at his request.Plan is to keep Mr.Edward NPO and place a peripheral line for hydration and nutrition support.

Question 15

Describe the procedures to be followed when administering medications to clients on feeding tubes.

Accepted Answer

When administering medications to client

Question 16

Standard IV amino acid solutions contain essential amino acids but no nonessential amino acids.

Accepted Answer

A) True 
 B)False

Question 17

Mr.Frank has a functioning GI tract, but minimal digestive and absorptive capacity.The nurse suggests that Mr.Frank receive a(n) _____ formula.

Accepted Answer

A) modular 
B) elemental 
C) parenteral 
D) standard 
A) modular 
B) elemental 
C) parenteral 
D) standard

Question 18

The nurse recognizes _____ as a possible preventive measure for aspiration pneumonia in tube-fed clients.

Accepted Answer

A) using nasoenteric feedings 
B) using a large-diameter transnasal tube 
C) delivering the feeding intermittently 
D) diluting the formula with water 
A) using nasoenteric feedings 
B) using a large-diameter transnasal tube 
C) delivering the feeding intermittently 
D) diluting the formula with water

Question 19

Which of the following feeding tube placement sites would be the most appropriate for a client who is expected to be on a tube feeding for less than 4 weeks?

Accepted Answer

A) gastrostomy 
B) jejunostomy 
C) nasogastric 
D) duodenostomy 
A) gastrostomy 
B) jejunostomy 
C) nasogastric 
D) duodenostomy

Question 20

Mr.Avery's physician is hopeful that his swallowing ability will improve in the coming weeks.Which feeding route would be most appropriate for Mr.Avery at this time?

Accepted Answer

A) orogastric 
B) nasojejunal 
C) nasogastric 
D) parenteral 
A) orogastric 
B) nasojejunal 
C) nasogastric 
D) parenteral

Exam 15: Enteral and Parenteral Nutrition Support

Describe the current procedure for administering a central TPN feeding.

Mrs.Winslow is receiving TPN.Today's lab work shows that her triglyceride level is 500 mg/dL.The nurse recognizes that:

Dextrose monohydrate provides _____ kcal/g.

Mr.White is feeling anxious about being on a tube feeding.The nurse can help alleviate his fears by all of the following except:

All of the following are characteristics of elemental formulas except:

Fiber in an enteral formula provides all of the following benefits except:

A drawback to using specialized or disease-specific formulas is:

A parenteral solution that contains dextrose, amino acids, and lipids is called a:

Mr.Edward's blood glucose level rises to 350 mg/dL.What will the health care team likely do about this?

Dietary treatment of galactosemia depends primarily on the elimination of:

A formula that approximates the osmolality of normal blood serum:

The nurse understands that infusing medications along with an enteral formula increases the osmolality of the tube feeding and may cause a patient to experience:

The nurse recognizes all of the following as advantages of enteral nutrition over parenteral nutrition except:

Mr.Avery's swallowing ability and oral intake are improving.He is now consuming about 2/3 of his estimated nutrient needs from oral intake.It would be appropriate at this time to:

Describe the procedures to be followed when administering medications to clients on feeding tubes.

Standard IV amino acid solutions contain essential amino acids but no nonessential amino acids.

Mr.Frank has a functioning GI tract, but minimal digestive and absorptive capacity.The nurse suggests that Mr.Frank receive a(n) _____ formula.

The nurse recognizes _____ as a possible preventive measure for aspiration pneumonia in tube-fed clients.

Which of the following feeding tube placement sites would be the most appropriate for a client who is expected to be on a tube feeding for less than 4 weeks?

Mr.Avery's physician is hopeful that his swallowing ability will improve in the coming weeks.Which feeding route would be most appropriate for Mr.Avery at this time?

Overview of Nutrition and Health

Digestion and Absorption

Carbohydrates

Lipids

Protein

Energy Balance and Body Composition

Weight Management

The Vitamins

Water and the Minerals

Nutrition Through the Life Span: Pregnancy and Infancy

Nutrition Through the Life Span: Childhood and Adolescence

Nutrition Through the Life Span: Later Adulthood

Nutrition Care and Assessment

Nutrition Intervention and Diet-Drug Interactions

Nutrition in Metabolic and Respiratory Stress

Nutrition and Upper Gastrointestinal Disorders

Nutrition and Lower Gastrointestinal Disorders

Nutrition and Liver Diseases

Nutrition and Diabetes Mellitus

Nutrition and Disorders of the Heart and Blood Vessels

Nutrition and Renal Diseases

Nutrition, Cancer, and Hiv Infection

Filters

Mr.Avery's swallowing ability and oral intake are improving.He is now consuming about ²/₃ of his estimated nutrient needs from oral intake.It would be appropriate at this time to: