Question 1

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. 
E)  often causes constipation with use.

Question 2

Name and discuss five metabolic complications that may result from parenteral feedings.

Accepted Answer

The answer of Name and discuss five metabolic complications that...

Question 3

Mr. Avery is a 77-year-old retired engineer. He is 5'10" tall and weighs 171 pounds. He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
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. 
E)  include a vitamin-mineral supplement with the tube feeding.

Question 4

Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with:
End-stage adenocarcinoma of the gastroesophageal juncture.
Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
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. A peripheral line for hydration and nutrition support has been inserted.
Which parenteral infusion complication is Mr. Edward at risk of developing?

Accepted Answer

A)  h ypoglycemia 
B)  r efeeding syndrome 
C)  h ypernatremia 
D)  h ypovolemia 
E)  m etabolic bone disease

Question 5

What describes an advantage of using a closed system for delivering enteral feedings?

Accepted Answer

A)  l ess likelihood of contamination 
B)  i ncreased nurse contact with the patient 
C)  r easonable cost and less expense 
D)  i ncreased patient tolerance 
E)  e nhanced flavor for the patient

Question 6

Types of formulas that contain intact proteins are called:

Accepted Answer

A)  disease-specific formulas. 
B)  hydrolyzed formulas . 
C)  standard formulas. 
D)  modular formulas. 
E)  monomeric formulas.

Question 7

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. 
E)  peanuts and tree nuts.

Question 8

Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with:
End-stage adenocarcinoma of the gastroesophageal juncture.
Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
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. A peripheral line for hydration and nutrition support has been inserted.
The nutrition support team determines how much carbohydrate, protein, fat, vitamins, minerals, and fluid they will administer to Mr. Edward. What component of Mr. Edward's peripheral nutrition infusion will provide the greatest number of kcalories in the smallest volume of fluid?

Accepted Answer

A)  250 mL of a 30% lipid emulsion 
B)  250 mL of a 10% dextrose solution 
C)  250 mL of a 10% amino acid solution 
D)  250 mL of a 10% lipid emulsion 
E)  250 mL of a 20% lipid emulsion

Question 9

Differentiate between the characteristics and uses of standard formulas and hydrolyzed formulas.

Accepted Answer

The answer of Differentiate between the characteristics and uses of...

Question 10

Long-term TPN administration may result in complications such as:

Accepted Answer

A)  gallbladder disease. 
B)  heart disease. 
C)  diabetes. 
D)  bone cancer. 
E)  hearing loss.

Question 11

The dextrose monohydrate used in parenteral nutrition solutions provides _____ kcal/g.

Accepted Answer

A)  0.9 
B)  1.8 
C)  2.5 
D)  3.4 
E)  4.2

Question 12

What type of enteral formulas are made from whole foods and derive their protein primarily from pureed meat?

Accepted Answer

A)  s tandard 
B)  h ydrolyzed 
C)  b lenderized 
D)  m odular 
E)  p olymeric

Question 13

What action would most likely prevent refeeding syndrome in a malnourished patient?

Accepted Answer

A)  Avoid adding dextrose to the TPN infusion. 
B)  Do not allow the patient to eat. 
C)  Provide extra vitamin supplements. 
D)  Include stomach acid-reducing medications in the TPN solution. 
E)  Start the patient's feedings at a slow rate.

Question 14

Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with:
End-stage adenocarcinoma of the gastroesophageal juncture.
Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
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. A peripheral line for hydration and nutrition support has been inserted.
Mr. Edward's blood glucose level rises to 350 mg/dL. What response from the health care team is most appropriate?

Accepted Answer

A)  Nothing; this is acceptable for a patient receiving TPN. 
B)  Taper off his lipid infusion. 
C)  Stop his TPN infusion entirely. 
D)  Infuse insulin with his TPN. 
E)  Change the dextrose concentration from 5% to 10%.

Question 15

Infants diagnosed with galactosemia are given formulas that do not contain:

Accepted Answer

A)  iron. 
B)  lactose. 
C)  tyrosine. 
D)  soy. 
E)  dextrose.

Question 16

Parenteral nutrition can be discontinued when _____ of estimated energy needs are being met by oral intake, tube feeding, or a combination of the two.

Accepted Answer

A)  35-50% 
B)  25-35% 
C)  35-75% 
D)  60-75% 
E)  80-90%

Question 17

Nursing Exam Review Multiple Choice The nurse is working with a patient who requires a tube feeding but who would like to return to work and resume other activities. What is the best way to feed this patient?

Accepted Answer

A)  u sing a nasojejunal tube 
B)  p roviding continuous feedings 
C)  u sing a nasogastric tube 
D)  low-profile gastrostomy 
E)  c hanging from tube feedings to parenteral feedings

Question 18

Highly concentrated nutrient solutions are not suitable for peripheral parenteral nutrition.

Accepted Answer

A) True 
 B)False

Question 19

What describes an advantage of using a nasogastric tube to provide enteral tube feedings?

Accepted Answer

A)  It is not easily removed if a patient is disoriented. 
B)  It has a low risk of aspiration. 
C)  It may allow enteral feedings even if an obstruction is present. 
D)  It is more comfortable when being inserted. 
E)  It is easy to insert and maintain.

Question 20

Before discontinuing a tube feeding, the patient's oral intake should meet about _____ of estimated nutrient needs.

Accepted Answer

A)  1/4 
B)  1/3 
C)  1/2 
D)  2/3 
E)  3/4

Exam 15: Enteral and Parenteral Nutrition Support