Deck 17: Nutritional Support

Question 1

The physician orders nutrient support for a client with a traumatic injury. The nurse recognizes the purpose of this order, which is to:

A) improve cardiac function.
B) enhance wound healing.
C) improve intestinal and liver blood flow.
D) improve general health.

Answer 1

enhance wound healing.

Question 2

A client is receiving total parenteral nutrition (TPN) via a central line. Which condition predisposes this client to infection?

A) High protein content in the TPN
B) WBC count of 7800/mm
C) Line being in a small IV line
D) Glucose content of the solution

Answer 2

Glucose content of the solution

Question 3

The most likely candidate for total parenteral nutrition is the client:

A) with a low risk of aspiration.
B) with a well-functioning GI tract.
C) without intravenous access.
D) diagnosed with malnutrition and cancer.

Answer 3

diagnosed with malnutrition and cancer.

Question 4

Water is an essential component in enteral feedings for the client because it:

A) keeps the solution intact.
B) increases the solution volume.
C) maintains hydration state.
D) decreases the thickness of the solution.

Question 5

A client is receiving 300 mL of Isocal every 4 hours by intermittent enteral feedings. What is the optimal method to receive the enteral feeding with this volume?

A) Direct use of a syringe or funnel
B) Infusion pump over 24 hours
C) Gravity drip or infusion pump over 30 to 60 minutes
D) Gravity drip or infusion pump over 8 to 16 hours

Question 6

A client is recovering from a cerebrovascular accident (stroke) and is receiving gastrostomy tube feedings. He is placed on aspiration precautions. What independent nursing action can the nurse implement?

A) Thicken the feedings with cereal.
B) Warm the formula.
C) Advance the feeding tube into the duodenum.
D) Elevate the head of the bed.

Question 7

A client has a large episode of diarrhea during an enteral feeding. What should be the first nursing action?

A) Slow the feeding.
B) Stop the feeding.
C) Call the physician.
D) Administer an antidiarrheal agent.

Question 8

Liquid medications should be diluted to reduce the osmolality of the drug to 500 mOsm. The client is to receive amoxicillin (Amoxil, Augmentin) 250 mg, qid. The medication is available as 50 mg/mL. The osmolality of amoxicillin is 2250 mOsm. How many milliliters of total liquid and medication should the client receive?

A) 5 mL
B) 10 mL
C) 17.5 mL
D) 22.5 mL

Question 9

A client receiving total parenteral nutrition for 3 days becomes disoriented and removes her intravenous line. A new line cannot be inserted for 2 to 3 hours. The nurse should monitor the client for:

A) hypoglycemia.
B) infection.
C) air embolism.
D) hyperglycemia.

Question 10

The client is being treated with total parenteral nutrition. She is experiencing cough, dyspnea, neck vein engorgement, chest rales, and weight gain. These symptoms most likely are the result of:

A) pneumothorax.
B) air embolism.
C) infection.
D) fluid overload.

Question 11

A client begins total parenteral nutrition to enhance nutritional status before surgery. The nurse is providing teaching about this treatment. Which statement by the client indicates a need for more teaching?

A) "The TPN fluid is a complete nutritional solution."
B) "I will urinate a lot because of the fluid and the sugar."
C) "I can take the IV dressing off in the shower."
D) "I need my urine and blood checked frequently."

Question 12

A client has been ordered to be treated with total parenteral nutrition (TPN). For which complications will the nurse monitor the client most closely?

A) Pulmonary embolism
B) Air embolism
C) Nausea and vomiting
D) Ascites

Question 13

The client most likely to be treated with total parenteral nutrition (TPN) is the client who has:

A) gastrointestinal (GI) dysfunction.
B) inadequate nutritional intake.
C) an intact gastrointestinal system.
D) a decreased immune system.

Question 14

The nurse instructs the client to prevent air embolism with total parenteral nutrition (TPN) by performing the Valsalva's maneuver. The nurse instruct the client to take a breath, then:

A) breathe rapidly.
B) hold it, and bear down.
C) exhale and bear down.
D) exhale and hold it.

Question 15

A nurse has checked the residual in a gastrostomy tube before providing a feeding for an adult client. The previous feeding of 240 mL was given 4 hours ago. The residual was 75 mL. What should the nurse do?

A) Administer the feeding as ordered.
B) Stop the infusion, wait 1 hour, and check the residual again.
C) Hold the feeding and call the physician for orders.
D) Administer half of the ordered feeding and then check residual.

Question 16

A client is to receive amoxicillin (Amoxil, Augmentin) suspension. The nurse recognizes which complication of the medication that is due to its hyperosmolar state?

A) Vomiting
B) Severe headaches
C) Diarrhea
D) Clotting abnormalities

Question 17

A nutritionist is working with a family discussing nutritional options for a client in a comatose state. Which statement is true of enteral feedings but not true of parenteral feedings?

A) They are more expensive.
B) They have a higher infection rate.
C) They pose a greater risk of aspiration.
D) They can be used with intestinal obstruction.

Question 18

A nurse is evaluating a client for commencement of enteral feedings. The most appropriate client to receive enteral feeding is the client who has _____ bowel sounds.

A) decreased
B) absent
C) intact
D) occasional

Question 19

What is a complication of total parenteral nutrition (TPN) not found with enteral feelings?

A) Dehydration
B) Aspiration if supine
C) Frequent diarrhea
D) Pneumothorax

Question 20

The client is being treated with total parenteral nutrition. He is experiencing sharp chest pain and decreased breath sounds. These symptoms most likely are the result of:

A) fluid overload.
B) infection.
C) air embolism.
D) pneumothorax.

Question 21

The client is being treated with enteral feeding. Before administering the feeding, the nurse plans to elevate the head of the client's bed _____ degrees.

A) 90
B) 45
C) 30
D) 15

Question 22

The client is being treated with total parenteral nutrition. The nurse is monitoring the client closely for evidence of infection during the first week of treatment. The nurse recognizes that the dressing over the catheter insertion site should be changed every _____ hours.

A) 48
B) 24
C) 16
D) 8