Deck 13: Food and Nutrient Delivery: Nutrition Support

Question 1

Which one of these routes of parenteral access is considered long term?

A) Peripheral intravenous catheter
B) Peripherally inserted central catheter
C) Single-lumen catheter inserted into the subclavian vein
D) Catheter inserted into the external jugular vein

Answer 1

B
Explanation: PICC lines are inserted into a vein in the antecubital area of the arm and threaded into the subclavian vein, allowing greater mobility for the patient and decreased infection risk. Tunneled versions of single- or multiple-lumen catheters into the subclavian or the external jugular vein are also types of long-term access. Peripheral IV catheters and single-lumen, nontunneled catheters placed in the subclavian or internal or external jugular veins are also short-term catheters.

Question 2

In general, a patient's parenteral feeding can be discontinued when enteral nutrition meets _____ of the patient's need.

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

Answer 2

C
Explanation: When a patient is meeting 75% of nutrition needs through either enteral or parenteral nutrition, the parenteral nutrition may be discontinued. This process may take up to 2 to 3 days as the patient is weaned from parenteral nutrition. Parenteral nutrition administration is not stopped at once because this could contribute to fluid and electrolyte imbalances or rebound hypoglycemia.

Question 3

After assessment of a patient has determined that oral intake is inadequate, what is the next determination to be made?

A) Is the GI tract functional?
B) What type of tube should be placed?
C) What type of formula should be used?
D) What amount and composition of TPN are appropriate?

Answer 3

A
Explanation: The choice for use of enteral versus parenteral nutrition should be made based on whether the GI tract is functioning and capable of supporting the use of enteral nutrition. If the GI tract works, the preference is to meet the patient's nutritional needs through enteral nutrition. Tube type, formula type, and TPN composition are all decisions that need to be made later.

Question 4

Which trace element needs to be initially given at higher levels when there is a risk of refeeding syndrome?

A) Zinc
B) Copper
C) Chromium
D) Phosphorus

Question 5

A patient is receiving an intravenous solution that provides 120 g of dextrose monohydrate. How many calories does this provide the patient?

A) 132 kcal
B) 240 kcal
C) 408 kcal
D) 480 kcal

Question 6

The osmolarity of a 1-L bottle of 5% dextrose solution is _____ mOsm/L.

A) 50
B) 500
C) 200
D) 250

Question 7

The most important technique for prevention of aspiration in an enterally fed patient is

A) to position the patient at a 45-degree angle for feeding.
B) to use a calorically dense enteral formula.
C) to use a large bore feeding tube.
D) to administer feedings at a slow rate.

Question 8

For a fluid-restricted patient, an appropriate formula to select for use would be _____ kcal/ml.

A) 0.8
B) 1
C) 1.2
D) 1.5

Question 9

A common complication of enteral tube feeding is

A) hyponatremia.
B) refeeding syndrome.
C) diarrhea.
D) hypoalbuminemia.

Question 10

The patient most likely to experience refeeding syndrome is a patient who has

A) enteral feeding initiated after 7 days NPO.
B) parenteral feeding initiated after 7 days NPO.
C) enteral feeding after 24 hours NPO.
D) parenteral feeding after 24 hours NPO.

Question 11

For the patient with delayed gastric emptying, nausea and vomiting, or other indications of risk of aspiration, the tube should be placed through the

A) mouth into the stomach.
B) nose into the stomach.
C) mouth into the duodenum or jejunum.
D) nose into the duodenum or jejunum.

Question 12

The functions of the _____ system are better maintained with enteral feedings than with parenteral feedings.

A) cardiovascular
B) renal
C) gastrointestinal
D) pulmonary

Question 13

The following is NOT a potential complication of nasoenteric feeding tubes.

A) Thrombophlebitis
B) Sinusitis
C) Vocal cord paralysis
D) Pulmonary injury

Question 14

In home care, what is the recommended administration method for enteral nutrition?

A) Bolus feeding
B) Gravity drip
C) Cyclic pump
D) Continuous pump

Question 15

Possible advantages of using homemade tube feedings include

A) they are better reimbursed by insurance.
B) they may help an immunocompromised patient.
C) they can be used with any French size feeding tube.
D) they can create a bond with the caretaker.

Question 16

The calorie concentration provided by most general-purpose formulas is _____ kcal/ml.

A) 0.5
B) 1 to 1.2
C) 1.5
D) 2

Question 17

What type of enteric tube enters the body at the nose and terminates at the stomach?

A) Nasogastric
B) Nasojejunal
C) Percutaneous endoscopic gastrostomy
D) Percutaneous endoscopic jejunostomy

Question 18

Which condition would most likely require parenteral nutrition as the medical nutrition therapy?

A) Severe acute pancreatitis
B) HIV/AIDS
C) Failure to thrive
D) Oral or esophageal trauma

Question 19

Feeding tube diameter is measured in

A) French size.
B) millimeters.
C) inches.
D) centimeters.

Question 20

The maximum osmolality of parenteral solution that the cephalic or brachial vein may tolerate for infusion is _____ mOsm/kg.

A) 300 to 500
B) 500 to 800
C) 800 to 900
D) 900 to 1200