Question 1

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 D

Question 2

Risks of total parenteral nutrition include: (Select all that apply.)

Accepted Answer

A)   diarrhea.
B)   elevated blood sugar.
C)   infection at the catheter site.
D)   volume overload. B,C,D

Question 3

In trauma patients,enteral nutrition via nasogastric tube feedings into the small bowel is best initiated within what time frame following the injury?

Accepted Answer

A)   24 hours
B)   48 hours
C)   7 days
D)   72 hours A

Question 4

A patient,who has a tube feeding,requires a chest x-ray study for evaluation of a cough.To reduce the risk of aspiration,the nurse:

Accepted Answer

A)   helps the radiology technician to position the patient to avoid dislodging the tube.
B)   holds feedings until placement has been verified.
C)   slows the infusion rate by half.
D)   stops feedings 10 to 15 minutes before placing flat to obtain the radiograph.

Question 5

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 6

Which statement(s)about total parenteral nutrition is (are)true? (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.

Question 7

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)   Fluid and electrolyte imbalances and sepsis
C)   Fluid overload and pulmonary edema
D)   Hypoglycemia and renal insufficiency

Question 8

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 9

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 10

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

Question 11

An important nutritional consideration in the elderly population is:

Accepted Answer

A)   decreased protein requirements.
B)   increasing caloric requirements with age.
C)   potential for drug-nutrient interaction related to polypharmacy.
D)   presence of other diseases that decrease caloric needs.

Question 12

The best nursing approach to prevent feeding tube obstruction is:

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 13

Which intervention(s)is (are)critical during intravenous lipid administration? (Select all that apply).

Accepted Answer

A)   Assess glucose levels.
B)   Change the tubing every 24 hours.
C)   Hold lipids when administering antibiotics through the same line.
D)   Monitor triglyceride levels.

Question 14

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 15

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

Accepted Answer

A)   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.

Question 16

Select the physiological reasoning behind enteral therapy as the preferred source of nutritional therapy.

Accepted Answer

A)   Gut overgrowth increases.
B)   Gastroparesis increases.
C)   Bacterial translocation is initiated.
D)   Gut mucosa is preserved.

Question 17

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

Accepted Answer

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

Question 18

A patient is being fed through a nasogastric tube placed in his stomach.The nurse would carry out which intervention to minimize aspiration risk?

Accepted Answer

A)   Add blue dye to the formula.
B)   Assess the residual every hour.
C)   Elevate the head of the bed 30 degrees.
D)   Provide feedings via continuous infusion.

Question 19

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

Question 20

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.

Exam 6: Nutritional Support