Question 1

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 D

Question 2

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. D

Question 3

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 B

Question 4

The best nursing approach to prevent feeding tube obstruction is to

Accepted Answer

A)   dilute the feeding to make it flow more easily.
B)   flush the tube every 4 hours with 20 to 30 mL of tap water.
C)   pass a stylet daily to keep the tubing clear.
D)   use a larger bore tube where possible.

Question 5

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.

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.

Question 7

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

Question 8

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.

Question 9

The correct order of actions for a patient starting enteral nutrition with a feeding tube is: _______________,_______________,_______________,_______________,_______________.
A) initiate tube feeding
B) insert feeding tube
C) flush tube to verify patency
D) obtain chest radiograph
E) assess residuals

Accepted Answer

The answer of The correct order of actions for a...

Question 10

A patient is receiving enteral tube feedings and has developed drug-nutrient interactions.The nurse recognizes which drug as having the potential for causing drug-nutrient reactions?

Accepted Answer

A)   Aspirin
B)   Enoxaparin
C)   Ibuprofen
D)   Phenytoin

Question 11

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

Question 12

Calorie-dense feedings:

Accepted Answer

A)   are most useful in heart failure and liver disease.
B)   are most useful in malabsorption syndromes.
C)   contain 2 kcal/mL and 70 g protein/L.
D)   include increased fiber.
E)   are especially good for patients with lung disease.

Question 13

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.

Question 14

Which of the following statements is true about insulin and parenteral nutrition?

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.

Question 15

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

Question 16

A patient has been admitted to the critical care unit after a stroke.After "failing" a swallow study,the patient is placed on enteral feedings.Following placement of a nasogastric tube for tube feeding,what is the next critical step?

Accepted Answer

A)   Administer medications.
B)   Cap off and wait 24 hours before starting feedings.
C)   Obtain a chest radiograph.
D)   Start the tube feeding.

Question 17

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?

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

Question 18

Which statements about total parenteral nutrition are correct?

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.

Question 19

Which interventions are critical during intravenous lipid administration?

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.

Question 20

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.

Exam 6: Nutritional Support