Deck 5: Enteral and Parenteral Nutrition Support

Question 1

What are the benefits of enteral formulas with fiber?

A)Fiber aids in the absorption of minerals.
B)Fiber helps prevent clogging of the feeding tube.
C)Fiber helps maintain normal bowel function.
D)Fiber reduces viscosity of the formula by attracting water.

Answer 1

C

Question 2

Which of the following feedings is isotonic?

A)Traumacal 425 mOsm/kg
B)Vivonex 550 mOsm/kg
C)Isocal 300 mOsm/kg
D)Boost 620 mOsm/kg

Answer 2

C

Question 3

Which of the following is a contraindication for tube feeding?

A)hypomotility of the small intestine
B)functioning GI tract, but patient cannot meet nutritional needs
C)protein-energy malnutrition
D)severe dysphagia (difficulty swallowing)

Answer 3

A

Question 4

In cases of gastroparesis, which methods of support would yield the best results?

A)nasogastric
B)nasoduodenal
C)orogastric
D)oral

Question 5

Your patient has had a portion of his stomach resected The physician predicts that he will likely be on nutrition support for a long time He has a functional GI tract What is the best way to feed this patient?

A)TPN
B)jejunostomy
C)PEG
D)PPN

Question 6

Which type of feeding tube is the most common, least expensive, and easiest to achieve and maintain?

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

Question 7

Formulas containing di- and tripeptides are termed:

A)intact.
B)hydrolyzed.
C)crystalline.
D)modular.

Question 8

A disadvantage of using the gastrostomy route for a tube feeding is:

A)the intestine does not have time to properly absorb the nutrients.
B)the feedings are sometimes regurgitated.
C)the feeding bypasses the stomach.
D)all of the above

Question 9

Which tube feeding administration is most useful for people who have poor tolerance to larger volumes of formula?

A)bolus
B)intermittent
C)continuous drip
D)combination

Question 10

Which of the following tube feedings would leave the least residue in the gut?

A)a blenderized formula
B)a hydrolyzed formula
C)a polymeric formula
D)a fiber-added formula

Question 11

Which of the following is true about enteral formulas?

A)They contain SCFA.
B)They are lactose free.
C)They are composed of dipeptides.
D)The source of fat is canola oil.

Question 12

You have a patient who weighs 215# and is on dialysis This patient often presents with edema Which of the following formulas would be best for this patient?

A)hydrolyzed
B)intact
C)nutrient dense
D)hepatic

Question 13

What is the consequence of a hyperosmolar formula?

A)excess kilocalories
B)diarrhea
C)excess fluid
D)delayed healing

Question 14

Which of the following is not a contraindication to enteral feeding?

A)paralytic ileus
B)nonresponsive, intractable vomiting and diarrhea
C)intestinal obstruction distal to tube
D)severe dysphagia

Question 15

Formulas containing crystalline amino acids are termed:

A)intact.
B)semi-elemental.
C)elemental.
D)modular.

Question 16

Your patient has Crohn's disease and presents with severe malabsorption Which of the following formulas would be best for this patient?

A)intact
B)immune enhancing
C)lactose free
D)hydrolyzed

Question 17

How much additional water would a patient with an energy requirement of 2400 kcal/day need if 2400 mL of a standard formula (85% water) were administered daily?

A)235 mL/day
B)360 mL/day
C)480 mL/day
D)125 mL/day

Question 18

Concern about the adverse side effects of long-chain fats has given rise to formulas supplemented with _____ to boost immunity

A)omega-3 fatty acids
B)MCT oil
C)FOS
D)CHO

Question 19

If a physician places a feeding tube through the skin and into the stomach without a surgical incision and using an endoscope, it is most specifically referred to as:

A)gastrostomy.
B)nasogastric.
C)orogastric.
D)PEG.

Question 20

A formula feeding that is administered within the space of a few minutes is a:

A)single feeding.
B)bolus feeding.
C)complete feeding.
D)quick delivery system.

Question 21

Your patient presents to the ER with intractable vomiting that is not responding to anti-nausea medications How do you feed this patient?

A)nasointestinal tube
B)gastrostomy
C)PN
D)jejunostomy

Question 22

If there is a concern that a client may not tolerate a tube feeding well it is wise to:

A)start the tube feeding at a very slow rate.
B)administer the tube feeding rapidly to provide as much formula as possible before complications occur.
C)start the tube feeding at half strength.
D)none of the above

Question 23

The caloric value of the carbohydrate source used in PN is:

A)4 kcal/g.
B)9 kcal/g.
C)3.4 kcal/g.
D)11 kcal/g.

Question 24

An isotonic tube feeding is often started at _____ mL/h, then gradually increased by _____ mL/h every 6-8 hours as tolerated until final volume is reached

A)50; 20
B)25; 50
C)100; 50
D)10; 10

Question 25

Your patient is a reported alcohol abuser and has been in and out of homeless shelters for 2 years He presents to the ER with a CVA and severe dysphagia and requires a feeding tube What complication is he at risk for developing?

A)refeeding syndrome
B)hypoglycemia
C)overhydration
D)hepatic steatosis

Question 26

The carbohydrate source used in PN is:

A)glucose.
B)intralipid.
C)disaccharides.
D)dextrose monohydrate.

Question 27

Protein is added to the solution by using:

A)di- and tripeptides.
B)complete proteins.
C)amino acids.

Question 28

If a patient's enteral volume requirement is 2100 mL/day, what will the final rate be?

A)88 mL/hr
B)100 mL/hr
C)50 mL/hr
D)75 mL/hr

Question 29

Which of the following access devices would be best for a patient requiring long-term PN who has body image concerns and would like something that can be hidden?

A)CVC
B)PICC
C)tunneled catheter
D)implantable port

Question 30

What type of lipid is commonly used to make the lipid used in TPN?

A)olive oil
B)egg phospholipid
C)stearic acid
D)soybean oil

Question 31

Which of the following would not be an effective measure of hydration status for a patient on tube feeding?

A)hydration is monitored by daily weights
B)hydration is monitored by interviews with the patient
C)hydration is monitored by BUN
D)hydration is monitored by urine specific gravity

Question 32

What EN complication should the RD particularly monitor for in a patient who is sedated, has an endotracheal tube, or has swallowing problems?

A)diarrhea
B)hyperglycemia
C)a clogged tube
D)aspiration

Question 33

The most commonly reported GI complication from enteral nutrition support is:

A)hepatic steatosis.
B)diarrhea.
C)constipation.
D)elevated LFTs.

Question 34

Your patient's PN is infusing from one bag This is called:

A)a two-in-one system.
B)a three-in-one system.
C)a closed system.
D)an open system.

Question 35

In PN, concentrations of up to 70% are used for:

A)protein.
B)carbohydrates.
C)lipids.
D)vitamins.

Question 36

The most common form of parenteral access is a(n):

A)CVC.
B)PICC.
C)PPN.
D)implantable port.

Question 37

Complications of EN delivered into the stomach could include:

A)ulcer.
B)gastric atrophy.
C)aspiration pneumonia.
D)edema.

Question 38

In which of the following clinical conditions might your patient benefit from a larger percentage of their kcal provided by lipid?

A)respiratory failure
B)liver failure
C)hyperglycemia
D)congestive heart failure

Question 39

Your patient has had multiple bowel resections and is being sent home on PN What is the best access option for this patient?

A)NDT
B)tunneled catheter
C)CVC
D)PICC

Question 40

Which of the following is not a side effect of excessive carbohydrate infusion via PN?

A)hyperglycemia
B)excessive CO₂ production
C)excess fluid infusion
D)hepatic steatosis

Question 41

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
What is the most important parameter for the RD to follow up on with this patient on the second day?

A)refeeding syndrome
B)gastrointestinal tolerance
C)dehydration
D)tube dislodgement

Question 42

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
How many milliliters of fluid per kilogram of body weight does he need?

A)20
B)25
C)30
D)40

Question 43

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
After selecting the formula that would best fit his nutrient needs, you determine that he needs ~ 1500 mL of formula per day Which of the following is the most appropriate schedule for him?
A)375 mL four times daily
B)100 mL eight times daily
C)35 mL per hour over 24 hours
D)75 mL per hour from 8 p.m.to 8

A)m.daily

Question 44

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
How many kcalories per kilogram of body weight would you use to estimate his caloric needs?

A)20
B)25
C)35
D)15

Question 45

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
How would you feed this patient?

A)nasogastric tube
B)nasointestinal tube
C)PEG
D)PN

Question 46

A common GI complication of PN when the bowel is at complete rest is:

A)diarrhea.
B)decreased LFTs.
C)hepatic steatosis.
D)cholestasis.

Question 47

Case Study Multiple Choice
You have an 80 yo M patient that has end-stage Alzheimer's disease and has recently been diagnosed with severe dysphagia.This patient is getting ready for discharge from the hospital.His height is 5' 9'' and he weighs 162# with no recent changes in weight.
How many grams of protein per kilogram of body weight does he need?

A)0.8
B)1.0
C)1.4
D)1.6

Question 48

Which of the following is true about PPN?

A)The formula is generally sufficient in protein and kilocalories.
B)It is administered through a central line.
C)It is indicated for long-term support.
D)The formula is dilute so it does not irritate veins.

Question 49

Which of the following is not routinely included in the parenteral solution, but may be added in some institutions?

A)medications
B)trace minerals
C)vitamins
D)electrolytes

Question 50

What lab value would you monitor to evaluate the tolerance to IV lipid?

A)albumin
B)triglycerides
C)glucose
D)creatinine