Deck 20: Enteral Nutrition Support

Question 1

Standard formulas are used for clients who ____. ​

A)require large amounts of kcalories
B)are able to digest and absorb nutrients
C)are severely malnourished
D)require intravenous feedings

Answer 1

B

Question 2

Standard formulas are also referred to as ____ formulas. ​

A)polymeric
B)MCT
C)elemental
D)modular

Answer 2

A

Question 3

The protein content of enteral formulas is usually ____ percent of total kcalories.

A)2 to 10
B)12 to 20
C)22 to 30
D)32 to 40

Answer 3

B

Question 4

In which patient should gastric feedings be avoided? ​

A)a pediatric patient
B)a patient at risk of aspiration
C)a patient with extremely high nutrient requirements
D)a patient with severe malnutrition

Question 5

Which condition or treatment may indicate the need for tube feedings? ​

A)obesity
B)mechanical ventilation
C)systemic infection
D)potassium depletion

Question 6

The fat content of enteral formulas is usually ____ percent of total kcalories. ​

A)5 to 10
B)15 to 30
C)35 to 50
D)55 to 60

Question 7

An opening in the abdomen through which a feeding tube can be passed to the stomach is called a(n)____. ​

A)ileostomy
B)endoscopic jejunostomy
C)gastrostomy
D)duodenostomy

Question 8

Which element is necessary for the use of enteral nutrition?

A)a functional GI tract
B)a good appetite
C)good peripheral venous access
D)minimal nutritional needs

Question 9

What is a good guideline for serving oral supplements to hospitalized patients? ​

A)Serve beverages in the can they come in, so that the patient can recognize them.
B)S erve beverages as cold as possible to minimize the often-unpleasant taste.
C)Serve the supplements attractively, in a glass on a plate, which may help patients consume them.
D)Serve the same flavor every day so that the patient will get used to them.

Question 10

Lora, age 57, is receiving chemotherapy and radiation for cancer and will soon have surgery. She is in need of oral supplementation to help improve her nutritional status prior to the surgery. What might be done to help her accept oral supplements?

A)Allow her to try several formulations to find one she likes.
B)Warn her that her surgery will have to be delayed if she does not accept them.
C)Give her a trial of tube feeding so she will prefer the oral supplements.
D)Acknowledge that they taste terrible but tell her they are better than the alternative.

Question 11

A disadvantage of transnasal tube placement is that ____. ​

A)it is not an effective means for tube feeding
B)the tube can be easily pulled out
C)the tube is inserted through the skin
D)the tube can be passed to the jejunum

Question 12

A general-purpose enteral formula that contains intact proteins is a(n)____ formula.

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

Question 13

Which feeding tube placement may require a surgical procedure? ​

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

Question 14

If a patient is going to be tube fed for longer than ____, a gastrostomy or jejunostomy may be necessary. ​

A)1 week
B)4 weeks
C)2 months ​
D)6 months

Question 15

The type of feeding tube that requires the most difficult insertion procedure is a(n)____ tube. ​

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

Question 16

Which feeding site is most appropriate for clients requiring long-term nutrition support? ​

A)enterostomy
B)nasoenteric
C)nasogastric
D)orogastric

Question 17

A(n)____ feeding tube placement may be preferred for infants because it allows normal breathing. ​

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

Question 18

Elemental formulas are also called ____ formulas . ​

A)polymeric
B)specialty
C)hydrolyzed
D)disease-specific

Question 19

Alan has been diagnosed with cancer and needs oral supplements to prevent weight loss. What oral supplement that can be purchased over-the-counter should be recommended for Alan?

A)Special K
B)Nutrisystem
C)SlimFast
D)Ensure

Question 20

Mr. Heiman has suffered a stroke and now has dysphagia (difficulty swallowing). He is 5'8" and weighs 127 pounds. The most appropriate method of nutrition support for him would be ____. ​

A)gastrostomy feedings
B)nasojejunal feedings
C)liquid supplements
D)jejunostomy feedings

Question 21

A formula with an osmolality greater than that of blood serum is known as a(n)____ formula . ​

A)isotonic
B)hypertonic
C)enteral
D)complete

Question 22

What can happen when medications are infused along with enteral feedings?

A)The osmotic load can increase substantially and may contribute to diarrhea.
B)Fluid overload can occur due to the additional need for water flushes.
C)Risk of aspiration increases due to the need for additional water flushes.
D)The medication can reach toxic levels in the body more easily.

Question 23

A health care provider is preparing to administer a tube feeding to a patient with a nasogastric tube. To best reduce the risk of formula contamination, the caregiver should perform which step first? ​

A)​C lean the lid of the can with an alcohol wipe.
B)​W arm the can in a pan of hot water.
C)​P our the contents of the can into a clean container.
D)​L abel the can with the date and time of its opening.

Question 24

A respiratory secretion sample typically  has a pH of ____. ​

A)3 or lower
B)​4
C)​5
D)​6 or higher

Question 25

The delivery of up to 500 mL of formula within 10 minutes is termed a(n)____. ​

A)minimal residual feeding
B)intermittent feeding
C)bolus feeding
D)a continuous drip

Question 26

Most enteral formulas have energy density of ____ kcalories per milliliter of fluid. ​

A)1.0 to 2.0
B)2.0 to 3.0
C)3.0 to 4.0
D)4.0 to 5.0

Question 27

What is a characteristic of an open feeding system?

A)A greater variety of formulas can be used.
B)The formula must be transferred from its original container.
C)An aseptic technique is not necessary.
D)This system costs more initially.

Question 28

The vast majority of patients use which type of enteral formula? ​

A)standard
B)hydrolyzed
C)specialized
D)modular

Question 29

A patient with fluid, electrolyte, and protein restrictions would most likely need which type of formula? ​

A)carbohydrate-modified
B)high-kcalorie
C)renal or hepatic insufficiency
D)standard formula with moderate fiber content

Question 30

What is a carbohydrate source used in many standard formulas? ​

A)aldose
B)maltodextrin
C)amylopectin
D)cellulose

Question 31

To reduce the risk of aspiration, the patient's upper body is elevated to a ____ degree angle during the feeding.

A)5 to 10
B)15 to 30
C)30 to 45
D)45 to 60

Question 32

Open containers of formula that are unused should be disposed of within ____ hours. ​

A)6 to 8
B)8 to 12
C)12 to 24
D)24 to 48

Question 33

A fasting gastric secretion sample typically has a pH of ____. ​

A)5 or lower
B)6 to 7
C)8 to 9
D)10 or higher

Question 34

What is a characteristic of a closed feeding system?

A)The formula can hang for a longer period of time.
B)It is more expensive in the long run.
C)Aseptic technique is not necessary.
D)It requires far more nursing time.

Question 35

Intermittent tube feedings are best tolerated when they are administered over ____. ​

A)5 to 10 minutes
B)30 to 45 minutes
C)1 to 2 hours
D)4 to 6 hours

Question 36

Proper sterile techniques should be used during preparation and delivery of formulas to protect patients from ____. ​

A)receiving the wrong formula
B)exposure to foodborne illness
C)malnutrition
D)dehydration

Question 37

Health care facilities have protocols for handling food products and formulas based on the potential hazards and critical control points in food preparation, which are called ____. ​

A)HACCP systems
B)Joint Commission mandates
C)MSDS requirements
D)AHA standards

Question 38

Iris has an order for continuous tube feedings through her nasogastric tube. She is to receive 2500 mL of formula on a continuous basis over 24 hours. What hourly rate should the healthcare provider set the pump at? ​

A)25 mL
B)58 mL
C)104 mL
D)250  mL

Question 39

Intermittent feeding using the gravity drip is suitable for the delivery of no more than how much formula over 30 minutes?

A)100 mL
B)200 mL
C)300 mL
D)400 mL

Question 40

When an open feeding system is used, the nurse should hang no more than a(n)____ hour supply. ​

A)​6
B)​8
C)​12
D)​16

Question 41

In the United States, phenylketonuria (PKU)affects approximately 1 out of ____ births annually. ​

A)​5,000
B)​12,700
C)​34,500
D)​150,000

Question 42

How often should the feeding tube be flushed if the patient is on continuous feedings? ​

A)every 4 to 6 hours
B)every 8 hours
C)every 12 hours
D)daily

Question 43

What is a potential metabolic complication of tube feedings? ​

A)elevated heart rate
B)hyperglycemia
C)increased vitamin C levels
D)redness and irritation at the tube insertion site

Question 44

For what purpose would a nurse measure the gastric residual volume in a patient's feeding tube? ​

A)to check that the stomach is emptying properly
B)to ensure that the patient is receiving adequate water
C)to prevent dumping syndrome and diarrhea
D)to ensure that medications have been digested

Question 45

Nondietary therapies can treat some inborn errors of metabolism. In some cases, the missing protein is infused, such as in the case of ____. ​

A)PKU
B)cystic fibrosis
C)hemophilia
D)galactosemia

Question 46

Mr. Simpson is receiving formula intermittently six times a day. He needs 1500 mL every 24 hours. How many milliliters of formula is Mr. Simpson receiving at each feeding?

A)120
B)250
C)​333
D)​900

Question 47

The only current treatment for phenylketonuria (PKU)is a diet that ____. ​

A)restricts phenylalanine and tyrosine
B)supplies tyrosine and valine
C)supplies valine and restricts phenylalanine
D)supplies tyrosine and restricts phenylalanine

Question 48

A patient who does not tolerate a bolus feeding would most likely develop what symptoms? ​

A)abdominal discomfort and nausea
B)headache and blurred vision
C)confusion and anxiety
D)constipation and edema

Question 49

Tom is a 15-year-old who is eating some but must also receive enteral feedings for malnutrition associated with Crohn's disease. To help Tom carry on normal activities, the health care team might try ____. ​

A)continuous feedings
B)intermittent feedings
C)a neon-colored feeding tube
D)brightly colored formulas

Question 50

Dietary changes may be able to improve outcomes of some inborn errors by ____. ​

A)promoting the accumulation of metabolites
B)providing a diet that supports growth and development
C)altering hormone levels to improve organ function
D)minimizing or eliminating symptoms of disease

Question 51

Nausea, vomiting, and cramps in a patient with a feeding tube are most likely caused by ____. ​

A)an inappropriate size feeding tube
B)inadequate fiber intake
C)a lack of exercise
D)delayed stomach emptying

Question 52

Why are bolus feedings used only in patients who are not critically ill?

A)Bolus feedings restrict the patient's movements for long periods of time.
B)Risk of aspiration is greater than with other delivery methods.
C)Bolus feedings wouldn't be adequate to meet the patient's nutrition needs in this situation.
D)Bolus feedings require the use of an infusion pump.

Question 53

Samuel is an 88-year-old patient with a gastrostomy tube. The healthcare provider knows that Samuel will not always recognize thirst, even though he may need extra water. To evaluate Samuel's hydration status, the provider will check his ____.

A)white blood cell count
B)respiratory rate
C)blood urea nitrogen
D)waist circumference

Question 54

A patient with a jejunostomy tube has developed an infection around the tube's insertion site. What measure would most likely correct this situation? ​

A)Use a small-bore tube.
B)Ensure that medication doses are appropriate.
C)Apply a protective dressing.
D)Remove the tube for 24 hours.

Question 55

The main focus of the dietary treatment for galactosemia is the ____. ​

A)exclusion of galactose
B)provision of galactose
C)exclusion of protein
D)provision of essential fatty acids

Question 56

A nurse determines that his patient's jejunostomy tube is clogged. What is a possible cause? ​

A)using liquid medications
B)using a viscous energy-dense formula
C)excessive water flushing
D)using a low-fiber formula

Question 57

Typically, adults require ____ mL/kg  of water daily.

A)5 to 8
B)10 to 12
C)15 to 20
D)30 to 40

Question 58

Which tube feeding delivery method is done every 3 to 4 hours using a syringe? ​

A)continuous feedings
B)bolus feedings
C)sustainable feedings
D)cyclic feedings

Question 59

Kristina is a 4-year-old with galactosemia. Her caregivers must ensure adequate intake of ____.

A)vitamin C
B)calcium
C)vitamin E
D)potassium

Question 60

How often should the feeding tube placement be checked if the patient is on intermittent feedings? ​

A)before each feeding is initiated
B)after each feeding
C)every 6 hours
D)every 12 hours

Question 61

Maureen Grey is a 75-year-old nursing home patient. She has been obtaining her nutrition via tube feeding for over three years. She is admitted to Good Valley Hospital with a diagnosis of dehydration with weight loss (8 pounds)in one month. Which type of tube feeding does Maureen most likely have? ​

A)nasogastric
B)orogastric
C)gastrostomy
D)double lumen

Question 63

Maureen Grey is a 75-year-old nursing home patient. She has been obtaining her nutrition via tube feeding for over three years. She is admitted to Good Valley Hospital with a diagnosis of dehydration with weight loss (8 pounds)in one month. While reviewing the nursing home's medical record, the nurse discovers that Maureen's weight loss can be linked to the addition of phenytoin, a medication that requires the tube feeding to be ____. ​

A)halted
B)increased
C)diluted
D)bolused

Question 65

Eighty-year-old Antonio Hernandez has a past medical history of hypertension, elevated cholesterol, and diabetes. He suffers a massive stroke and is stabilized in the CCU (coronary care unit). It is determined that it is unsafe to feed him orally and a tube feeding will be started immediately. ​ The nurse will determine whether Antonio is tolerating the tube feeding by ____.

A)diluting the formula
B)adding dye to the formula
C)checking gastric residuals
D)adding drug therapy

Question 67

Eighty-year-old Antonio Hernandez has a past medical history of hypertension, elevated cholesterol, and diabetes. He suffers a massive stroke and is stabilized in the CCU (coronary care unit). It is determined that it is unsafe to feed him orally and a tube feeding will be started immediately. Which nutrient(s)must be supplemented in order to meet Antonio's nutritional needs? ​

A)protein
B)vitamins and minerals
C)MCT
D)water

Question 68

Eighty-year-old Antonio Hernandez has a past medical history of hypertension, elevated cholesterol, and diabetes. He suffers a massive stroke and is stabilized in the CCU (coronary care unit). It is determined that it is unsafe to feed him orally and a tube feeding will be started immediately. Which formula would be the most appropriate for Antonio? ​

A)modular
B)blenderized
C)specialized
D)elemental

Question 70

Maureen Grey is a 75-year-old nursing home patient. She has been obtaining her nutrition via tube feeding for over three years. She is admitted to Good Valley Hospital with a diagnosis of dehydration with weight loss (8 pounds)in one month. In order to prevent further weight loss and to better meet nutritional needs, the dietitian will recommend a(n)____ formula for Maureen . ​

A)standard
B)energy-dense
C)low-fiber
D)isotonic

Question 71

Maureen Grey is a 75-year-old nursing home patient. She has been obtaining her nutrition via tube feeding for over three years. She is admitted to Good Valley Hospital with a diagnosis of dehydration with weight loss (8 pounds)in one month. Maureen obtains 100 percent of her nutrients via her tube feeding. However, she is found to have food poisoning ( Salmonella ). What is the most plausible cause? ​

A)closed system feeding
B)open system feeding
C)improper hand washing
D)improper tube placement

Question 77

Maureen Grey is a 75-year-old nursing home patient. She has been obtaining her nutrition via tube feeding for over three years. She is admitted to Good Valley Hospital with a diagnosis of dehydration with weight loss (8 pounds)in one month. ​ What may have caused Maureen to become dehydrated?

A)dysphagia
B)food allergy
C)tube feeding rate
D)diarrhea

Question 78

Eighty-year-old Antonio Hernandez has a past medical history of hypertension, elevated cholesterol, and diabetes. He suffers a massive stroke and is stabilized in the CCU (coronary care unit). It is determined that it is unsafe to feed him orally and a tube feeding will be started immediately. For the first 24 hours, Antonio's tube feeding should be delivered by a(n)____ feeding method. ​

A)continuous
B)daily
C)intermittent
D)bolus

Question 80

Eighty-year-old Antonio Hernandez has a past medical history of hypertension, elevated cholesterol, and diabetes. He suffers a massive stroke and is stabilized in the CCU (coronary care unit). It is determined that it is unsafe to feed him orally and a tube feeding will be started immediately. ​ Which feeding route would be the most appropriate for Antonio?

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