Deck 19: Nutrition Support: Enteral and Parenteral Nutrition

Question 1

Complications associated with parenteral nutrition include:

A) low blood glucose levels.
B) electrolyte abnormalities.
C) loss of appetite.
D) depression.

Answer 1

B

Question 2

The person who is most likely to have a high risk of malnutrition is one with:

A) a superficial first-degree burn.
B) chronic disease.
C) cataracts.
D) a heart attack.

Answer 2

B

Question 3

Essential fuel sources for critically ill patients are:

A) dextrose and lipid emulsions.
B) protein and vitamins.
C) glucose and electrolytes.
D) glucose and protein.

Answer 3

D

Question 4

In most critically ill patients, energy needs do not exceed basal energy needs by more than:

A) 10%.
B) 20%.
C) 30%.
D) 50%.

Question 5

The nutrient density of most commercial enteral formulas is:

A) 1 to 2 kcal/mL.
B) 2 to 5 kcal/mL.
C) 4 to 5 kcal/mL.
D) 4 to 10 kcal/mL.

Question 6

Subjective global assessment relies on information from:

A) history and physical examination.
B) biochemical and anthropometric data.
C) the patient's own assessment of his or her condition.
D) the health care team's collective opinions.

Question 7

The types of carbohydrate most commonly used in enteral nutrition formulas are:

A) polysaccharides and oligosaccharides.
B) glucose polymers.
C) dextrose.
D) monosaccharides.

Question 8

A client would be a candidate for total parenteral nutrition (TPN) if he or she had:

A) a poor appetite after major surgery.
B) severe depression and unwillingness to eat.
C) radiation enteritis causing minimal food intake for over 2 weeks.
D) lost more than 10% of usual body weight in the past 9 months.

Question 9

Measurement of nitrogen balance requires:

A) an accurate 24-hour urine collection.
B) a 24-hour feces collection.
C) measurement of serum albumin.
D) high protein intake.

Question 10

Lactose is not usually used in commercial enteral nutrition formulas because:

A) it is too sweet.
B) it exerts too much osmotic pressure.
C) lactose intolerance is common in critically ill patients.
D) it interferes with drug absorption.

Question 11

The most important factor in decisions concerning use of parenteral nutrition is:

A) age.
B) gender.
C) competence of the clinical nutritionist.
D) status of the gastrointestinal tract.

Question 12

When an open delivery system is used for tube feeding, the maximum hang time for the formula is:

A) 2 hours.
B) 8 hours.
C) 24 hours.
D) 48 hours.

Question 13

The timing of beginning nutrition support depends on the patient's:

A) age.
B) weight.
C) nutritional status.
D) personal preferences.

Question 14

If a patient's dietary intake is inadequate, the first step in nutrition support should be to:

A) prescribe vitamin supplements.
B) begin parenteral nutrition.
C) begin enteral tube feeding.
D) provide small, frequent meals and liberalize modified diets.

Question 15

During critical illness, plasma levels of the hepatic proteins (albumin, transferrin, and prealbumin) generally indicate:

A) overall nutritional status.
B) hydration status.
C) risk of morbidity and mortality.
D) nitrogen balance.

Question 16

Energy needs may be 50% to 100% above basal energy expenditure in patients with:

A) sepsis.
B) severe burns.
C) bone fractures.
D) cancer cachexia.

Question 17

The Mifflin-St. Jeor equations for calculating basal energy expenditure are based on:

A) sex and weight.
B) lean body mass and age.
C) sex, height, weight, and age.
D) sex, height, and ideal body weight.

Question 18

Prebiotics or probiotics may be added to enteral formulas to improve:

A) the viscosity of the formula.
B) the osmolality of the formula.
C) the intestinal flora in the gastrointestinal tract.
D) motility in the gastrointestinal tract.

Question 19

A problem associated with use of blenderized formulas is:

A) lack of flavor.
B) lack of viscosity.
C) bacterial contamination.
D) nutrient density.

Question 20

If a patient weighed 150 lb 6 months ago and now weighs 130 lb, the weight loss would be considered:

A) mild.
B) moderate.
C) significant.
D) severe.

Question 21

Nasoenteric tubes can be inserted into the stomach, duodenum, and:

A) rectum.
B) jejunum.
C) ileum.
D) gallbladder.

Question 22

In enteral nutrition formulas that contain amino acids, the form of the amino acids is:

A) simple.
B) complex.
C) hydrolyzed.
D) crystalline.

Question 23

One form of protein that is often used in standard enteral nutrition formulas is:

A) denatured.
B) intact.
C) essential.
D) incomplete.

Question 24

A rich source of the essential fatty acids linoleic and linolenic acids is:

A) vegetable oil.
B) butterfat.
C) monoglycerides.
D) diglycerides.

Question 25

Weight should be measured daily in patients receiving nutrition support to help determine their:

A) nutritional status.
B) hydration status.
C) energy balance.
D) nitrogen balance.

Question 26

Peripheral parenteral nutrition is appropriate when the patient requires parenteral nutrition for less than:

A) 5 days.
B) 7 days.
C) 14 days.
D) 20 days.

Question 27

A common definition of diarrhea is:

A) more than three stools per day or greater than 500 mL of stool per day for 2 consecutive days.
B) more than five stools per day for 3 consecutive days.
C) more than three watery stools in 4 hours accompanied by signs of dehydration.
D) at least 200 g of unformed stool for 3 consecutive days.

Question 28

Formula intolerance may be indicated by:

A) bloating and constipation or diarrhea.
B) consistent daily weight and fluid balance.
C) patient fatigue and weakness.
D) low serum albumin and transferrin levels.

Question 29

Patients who are receiving enteral feedings should:

A) sit upright in a chair.
B) have the head of the bed elevated 30 to 45 degrees.
C) have their head and feet elevated 30 to 45 degrees.
D) lie flat.

Question 30

The preferred route for long-term enteral feeding is:

A) nasogastric.
B) enterostomal.
C) nasoenteric.
D) peripheral vein.

Question 31

Clients who are on ventilators, are restrained, are comatose, or have a depressed gag reflex and are receiving tube feedings should have feeding tubes placed into the:

A) jejunum.
B) stomach.
C) ileum.
D) duodenum.

Question 32

Osmotic pressure (osmolality) of an enteral nutrition formula is determined by the:

A) amount of fat in the solution.
B) size of particles in the solution.
C) viscosity of the solution.
D) number of particles in the solution.

Question 33

Individual intolerance of a formula is most likely to be caused by:

A) drug interactions.
B) temperature.
C) osmolarity.
D) the form of fat used.

Question 34

Signs of overhydration include:

A) elevated blood urea nitrogen level.
B) weight loss.
C) decreased blood pressure.
D) edema.

Question 35

The American Medical Association recommends that trace elements added to parenteral nutrition solutions should include:

A) iron, zinc, calcium, and phosphorus.
B) sodium, potassium, copper, and chloride.
C) zinc, copper, manganese, and chromium.
D) manganese, selenium, fluoride, and iron.

Question 36

If a tube-fed patient has blood glucose values higher than 200 mg/dL, he or she should be given:

A) insulin.
B) a prokinetic agent.
C) formula with added fiber.
D) a low-carbohydrate formula.

Question 37

If a client requires parenteral nutrition for the next 4 months, the route of choice for feeding will probably be via a:

A) nasogastric tube.
B) central vein.
C) nasoenteric tube.
D) peripheral vein.

Question 38

The most appropriate route of feeding for a client with gastric cancer is via a(n):

A) esophagostomy.
B) gastrostomy.
C) jejunostomy.
D) ileostomy.

Question 39

Regular monitoring of a client who is receiving tube feeding includes:

A) serum sodium and potassium.
B) serum albumin, prealbumin, and transferrin.
C) 24-hour urine and clean-catch urine.
D) serum iron.

Question 40

In critically ill patients, tolerance of enteral tube feedings is generally best when feedings are:

A) continuous.
B) intermittent.
C) boluses.
D) cyclic.

Question 41

The amount of energy provided by dextrose in parenteral nutrition solutions is:

A) 2.4 kcal/g.
B) 3.4 kcal/g.
C) 4.0 kcal/g.
D) 4.3 kcal/g.

Question 42

Intravenous iron should be given to patients receiving parenteral nutrition:

A) daily.
B) weekly.
C) as a separate injection.
D) only if they have anemia.

Question 43

The form of protein used in standard parenteral nutrition solutions is:

A) hydrolyzed protein.
B) essential amino acids.
C) crystalline amino acids.
D) branched-chain amino acids.

Question 44

Placement of enteral feeding tubes should be confirmed using:

A) x-ray examination.
B) magnetic resonance imaging.
C) manual verification.
D) aspirates of gastrointestinal fluids.

Question 45

To prevent essential fatty acid deficiency, the percentage of energy provided by lipid in parenteral nutrition solutions should be at least:

A) 1% to 2%.
B) 2% to 4%.
C) 4% to 10%.
D) 10% to 15%.

Question 46

The percentage of energy provided by protein in parenteral nutrition is normally:

A) 10% to 15%.
B) 10% to 20%.
C) 15% to 20%.
D) 20% to 30%.