Question 1

The nurse would write in the care plan for a client receiving enteral feedings to weigh the client on which of the following schedules?&#10;A) Monday and Thursday&#10;B) Monday,Wednesday,and Friday&#10;C) Every other day&#10;D) Every day&#10;

Accepted Answer

Monday,Wednesday,and Friday

Question 2

The nurse consults with the physician about a dosage adjustment for which of the following medications for a client who is beginning enteral feedings?&#10;A) Warfarin (Coumadin)&#10;B) Furosemide (Lasix)&#10;C) Lisinopril (Prinivil)&#10;D) Ibuprofen (Motrin)&#10;

Accepted Answer

Warfarin (Coumadin) dosage may need adjustment when a patient starts enteral feedings because the absorption of the medication can be altered by changes in the gastrointestinal tract's function and the presence of food, potentially affecting its efficacy and the patient's INR levels.

Question 3

A nurse who changes an enteral feeding administration set and adds feeding solution to the bag at 08:00 should make note that new solution must be placed in the bag no later that what time the same day?

A) 12:00
B) 16:00
C) 20:00
D) 22:00

20:00

Accepted Answer

The nurse should change the feeding solution every 24 hours or according to facility policy, whichever comes first. Since the feeding solution was added at 08:00, it should be changed no later than 08:00 the next day. However, since the nurse added the solution at 08:00, the solution should be changed 12 hours later, which would be at 20:00.

Question 4

The nurse should formulate which of the following nursing diagnoses for the client receiving total parenteral nutrition?&#10;A) Risk for imbalanced nutrition: more than body requirements&#10;B) Risk for aspiration&#10;C) Risk for excess fluid volume&#10;D) Risk for disturbed body image&#10;

Accepted Answer

Total parenteral nutrition (TPN) bypasses the normal digestion in the gastrointestinal tract and is administered directly into the bloodstream, which can lead to fluid overload if not carefully monitored and managed, hence the risk for excess fluid volume.

Question 5

A client is receiving enteral feedings by intermittent administration every 4 hours while awake,on a schedule of 08:00,12:00,16:00,and 20:00.After administering the 08:00 feeding,the nurse should plan to check for residual at which of the following times?

A) 08:30
B) 09:00
C) 10:00
D) 11:30

Accepted Answer

It is recommended to check residual every 4-6 hours for intermittent feedings, and since the next feeding is scheduled for 12:00, checking at 10:00 would fall within that time frame. Checking at 08:30 would be too soon and checking at 09:00 would not allow enough time for the feeding to progress. Checking at 11:30 would be too close to the next feeding time.

Question 6

Which of the following laboratory parameters alerts the nurse to malnutrition?&#10;A) Serum SGOT&#10;B) Reduced total lymphocyte count&#10;C) Elevated serum albumin&#10;D) Decrease in 24-hour urine urea nitrogen&#10;

Accepted Answer

Reduced total lymphocyte count is a laboratory parameter that indicates malnutrition. Lymphocytes are important in mounting an adequate immune response, and malnutrition can affect the function and number of these cells. The other choices (A, C, D) are not typically used to assess malnutrition.

Question 7

One of the best ways to prevent residue buildup that can result in the clogging of an enteral feeding tube is by&#10;A) pulling the tube out every 8 to 12 hours.&#10;B) using only transnasal tube placement.&#10;C) flushing the tube with 30 mL of mineral oil every day.&#10;D) flushing the tube every 4 hours with 20 mL of cranberry juice.&#10;

Accepted Answer

Flushing the tube every 4 hours with 20 mL of cranberry juice can help prevent residue buildup due to its acidic nature, which may help dissolve potential clogs.

Question 8

According to the current evidence,the nurse checking the residual volume for a client's enteral feeding would return the feeding to the client as long as it is less than how many milliliters?&#10;A) 100&#10;B) 250&#10;C) 400&#10;D) 500&#10;

Accepted Answer

The answer of According to the current evidence,the nurse checking...

Question 9

The nurse expects that a client who is malnourished will have which of the following alterations in health?&#10;A) Muscle hypertrophy&#10;B) Accelerated wound healing&#10;C) Resistance to infection&#10;D) Impaired immunocompetence&#10;

Accepted Answer

Malnourishment can lead to impaired immunocompetence, which means the body is less able to fight off infections and illnesses. The other options, muscle hypertrophy, accelerated wound healing, and resistance to infection, are not typically associated with malnutrition.

Question 10

The nurse anticipates that a client admitted today with a large enterocutaneous fistula will have nutritional needs optimally met by instituting which of the following methods of nutrition?&#10;A) Enteral feeding with an isotonic formula&#10;B) Enteral feeding with a specialized formula&#10;C) Peripheral parenteral nutrition&#10;D) Total parenteral nutrition&#10;

Accepted Answer

Total parenteral nutrition (TPN) is the best method of nutrition for a client with a large enterocutaneous fistula as it bypasses the gastrointestinal tract, allowing the bowel to rest and heal. TPN provides complete nutrition and is delivered intravenously, directly into the bloodstream. This method meets the client's nutritional needs and can prevent malnutrition and further complications. Enteral feeding with either isotonic or specialized formulas would not be appropriate as it would stimulate bowel function, potentially exacerbating the fistula. Peripheral parenteral nutrition may not provide complete nutrition and is typically used for short-term nutritional support.

Question 11

The nurse checks a residual volume on a client receiving enteral feedings at a rate of 125 mL/hr.The nurse would withhold the feeding and notify the prescriber if the residual volume was greater than&#10;A) 50 mL.&#10;B) 100 mL.&#10;C) 175 mL.&#10;D) 250 mL.&#10;

Accepted Answer

The answer of The nurse checks a residual volume on...

Question 12

Which of the following nursing diagnoses should the nurse include in the care plan for a client who is starting enteral nutrition by nasogastric tube today?&#10;A) Risk for constipation&#10;B) Risk for aspiration&#10;C) Excess fluid volume&#10;D) Imbalanced nutrition: more than body requirements&#10;

Accepted Answer

The answer of Which of the following nursing diagnoses should...

Question 13

A client receiving total parenteral nutrition asks the nurse whether she can at least take her daily multivitamin by mouth.Which of the following responses by the nurse is best?&#10;A) &#34;Yes,it won't be harmful to swallow just one pill per day.&#34;&#10;B) &#34;Yes,and a mineral supplement would be beneficial also.&#34;&#10;C) &#34;No,the basic solution contains all vitamins and minerals.&#34;&#10;D) &#34;No,because these are added to the solution every other day.&#34;&#10;

Accepted Answer

The answer of A client receiving total parenteral nutrition asks...

Question 14

The nurse should write on the care plan to monitor the weight of a client starting total parenteral nutrition at which of the following intervals?&#10;A) Monday and Thursday&#10;B) Monday,Wednesday,and Friday&#10;C) Every other day&#10;D) Daily&#10;

Accepted Answer

The answer of The nurse should write on the care...

Question 15

The nurse assesses a client suspected of developing an osmotic intolerance to an enteral feeding for which of the following symptoms?&#10;A) Decreased gastric motility&#10;B) Hypoglycemia&#10;C) Abdominal cramping&#10;D) Decreased gag reflex&#10;

Accepted Answer

The answer of The nurse assesses a client suspected of...

Question 16

The nurse is aware that a client with malabsorption syndrome is not a good candidate for enteral therapy with which of the following types of enteral formulations?&#10;A) Oligomeric&#10;B) Polymeric&#10;C) Monomeric&#10;D) Specialized&#10;

Accepted Answer

The answer of The nurse is aware that a client...

Question 17

The nurse concludes that a client is a candidate for enteral nutrition by nasogastric tube as long as the client can begin taking a diet within how many weeks?&#10;A) One&#10;B) Two&#10;C) Three&#10;D) Four&#10;

Accepted Answer

The answer of The nurse concludes that a client is...

Question 18

The nurse would comply with safe medication administration guidelines by administering which of the following crushed medication forms by enteral tube?&#10;A) Sustained-release capsule&#10;B) Sublingual tablet&#10;C) Enteric-coated tablet&#10;D) Tablet&#10;

Accepted Answer

The answer of The nurse would comply with safe medication...

Question 19

The nurse interprets that a client with which of the following conditions would benefit from an enteral feeding with an elemental formulation?&#10;A) Hyperglycemia&#10;B) Hyperosmolar coma&#10;C) Radiation enteritis&#10;D) Heart failure&#10;

Accepted Answer

The answer of The nurse interprets that a client with...

Question 20

The nurse concludes that a client receiving enteral feedings by which of the following methods is at the least risk of the complication of dumping syndrome?&#10;A) 250 mL bolus every 4 hours&#10;B) 400 mL bolus every 6 hours&#10;C) Intermittent feedings by drip over a 30-minute period&#10;D) Continuous feedings over a 24-hour period&#10;

Accepted Answer

The answer of The nurse concludes that a client receiving...

Question 21

The nurse expects that a client being started on total parenteral nutrition will have an order to set the infusion pump at a maximum of how many milliliters per hour for the first 4 to 6 hours of therapy?

A) 25
B) 50
C) 75
D) 100

Accepted Answer

The answer of The nurse expects that a client being...

Question 22

The nurse would report to the physician which of the following laboratory values for a client receiving total parenteral nutrition?&#10;A) Serum glucose 225 mg/dL&#10;B) Serum potassium 3.8 mEq/L&#10;C) Serum sodium 144 mEq/L&#10;D) Blood urea nitrogen 18 mg/dL&#10;

Accepted Answer

The answer of The nurse would report to the physician...

Question 23

The nurse concludes that total parenteral nutritional therapy is successful when the client who weighted 132 pounds initially demonstrates which of the following weights 1 week later?&#10;A) 133&#10;B) 134&#10;C) 137&#10;D) 138&#10;

Accepted Answer

The answer of The nurse concludes that total parenteral nutritional...

Question 24

A nursing responsibility associated with the care of the client that is specific to the total parenteral solution includes which of the following?&#10;A) Maintaining sterile asepsis when handling the site or solution&#10;B) Protecting the solution from exposure to light at all times&#10;C) Mixing the solution every 48 to 72 hours and keeping it at room temperature&#10;D) Adding any intravenous medications to the total parenteral solution&#10;

Accepted Answer

The answer of A nursing responsibility associated with the care...

Question 25

A hospitalized adult was started on total parenteral nutrition at 12:00.The nurse documents that the client's blood glucose level needs to be checked at which of the following optimal times?&#10;A) 12:30&#10;B) 14:00&#10;C) 18:00&#10;D) 22:00&#10;

Accepted Answer

The answer of A hospitalized adult was started on total...

Deck 69: Enteral and Parenteral Nutrition