Deck 5: Nutrition and Gastrointestinal Tube Therapy

Question 1

When discussing nutrition, what does the faculty member teach the students?

A) Essential nutrients are those we must eat.
B) Nonessential nutrients are good, but not necessary.
C) Micronutrients supply most of the essential nutrients.
D) Macronutrients supply the body with vitamins.

Answer 1

Essential nutrients are those we must eat.

Question 2

When teaching a client about nutrition, why would the nurse refer a client to MyPlate.gov?

A) To learn how various nutrients work in the body
B) To see the nutrition needs at each stage of life
C) To get a visual representation of a healthy meal
D) To find the recommended daily amounts of iron

Answer 2

To get a visual representation of a healthy meal

Question 3

A nurse is caring for a client and notices that after each meal, the client becomes hoarse. What action by the nurse is best?

A) Request an ENT consultation from the provider.
B) Ensure the client doesn't get extremely hot food.
C) Assess the client further for possible aspiration.
D) Provide the client with plenty of fluids with meals.

Answer 3

Assess the client further for possible aspiration.

Question 4

The nurse concerned about a client's nutritional status would request an order for which laboratory value?

A) Protein
B) Albumin
C) Hemoglobin
D) Pre-albumin

Question 5

A client weighed 186 pounds (84.54 kg) on admission. One week later the client weighs 172.98 pounds (78.62 kg). What action by the nurse is best?

A) Document the findings in the record.
B) Perform a thorough nutrition screen.
C) Consult with a registered dietitian.
D) Order high protein in between meal snacks.

Question 6

A client at risk for aspiration has finished a meal. What assessment by the nurse indicates that a priority goal for this client has been met?

A) The client ate at least 80% of the meal.
B) The client's lungs are clear bilaterally.
C) The client does not report coughing.
D) The client's meal was appropriate.

Question 7

The student nurses are assisting patients with physical and/or cognitive impairments. Which technique by a student shows good understanding of this process?

A) Visually impaired: Tells client where items are using the clock method
B) Physically impaired: Provides sharp knives so cutting is not so difficult
C) Partial facial paralysis: Place foods and straws on the affected side
D) Needs to be fed: Gives client all solid food first, followed by liquids

Question 8

A nurse is caring for a client with a nasogastric (NG) tube. What assessment finding would the nurse report to the provider immediately?

A) Absence of bowel sounds
B) Client report of discomfort
C) Bloody drainage from the NG
D) Dry oral mucous membranes

Question 9

What is the most important consideration for the nurse when caring for the client who has a Levin tube?

A) Ensuring placement prior to feeding
B) Keeping the suction on low settings
C) Fastening the tube securely to the client
D) Providing frequent oral care

Question 10

A nurse has inserted a nasogastric tube in a client for feedings. After the tube has been advanced into place and secured, what action does the nurse take next?

A) Begin the tube feedings.
B) Perform the "swoosh" test.
C) Notify the provider.
D) Obtain a chest x-ray.

Question 11

The nurse supervising students would intervene when a student attempted to place an NG tube in which client?

A) Client needing gastric decompression
B) Client with shellfish and iodine allergies
C) Client with recent sinus surgery
D) Client needing short-term feedings

Question 12

The new nurse is caring for a client receiving continuous tube feeding through a set that includes a bag and uses a pump to deliver the formula. What action by the nurse demonstrates good understanding of administering tube feedings?

A) Changes tube feeding set and supplies every 48 hours
B) Adds additional formula to the bag before it runs dry
C) Wipes the top of the formula can off before opening it
D) Limits pre-prepared formula "hang time" to 6 hours

Question 13

A 6-year old child starts crying when the nurse brings formula in to start the tube feeding. What action by the nurse is best?

A) Ask the child why he or she is crying right now.
B) Tell the child that "big kids' don't cry with feeding.
C) Promise the child a reward if he or she stops crying.
D) Encourage the family to help make this "mealtime" as normal as possible.

Question 14

A nurse is inserting a small-bore feeding tube. What action by the nurse is best?

A) Lubricates the tube with a petroleum-based product
B) Angles the tube up towards the nose during insertion
C) Leaves the stylet in to facilitate tube patency
D) Has client flex the neck downward during insertion

Question 15

The nurse caring for a pediatric client with PEG tube feedings enters the room and sees the enteral device on the floor. What action by the nurse is best?

A) Reinsert the device as soon as possible.
B) Call central supply for a new device.
C) Notify the provider right away.
D) Cover the entry site with sterile gauze.

Question 16

The nurse has properly identified the client and the validated the correct tube feeding formula. After checking for tube placement per agency policy, what action by the nurse is most important?

A) Pour the formula in the feeding bag.
B) Trace the tube to its point of origin.
C) Call radiology for an abdominal x-ray.
D) Turn the feeding pump to the ordered rate.

Question 17

A client's white blood cell count and pre-albumin are severely decreased. What assessment finding does the nurse correlate with this laboratory result?

A) Pocketing food during meals
B) A nonhealing pressure wound
C) Weight less than normal for height
D) 10-pound weight loss in a month

Question 18

An adult client has dry, brittle hair; a weak handgrip; and generalized edema. What lab value does the nurse correlate with this appearance?

A) Albumin: 2.4 g/dL (24 g/L SI unit)
B) Pre-albumin: 32 g/dL (320 g/L, SI unit)
C) Hematocrit: 46% (0.46 volume fraction)
D) Total lymphocyte count: 3300/mm³

Question 19

The nurse works with patients on different types of texture-modified diets, including the National Dysphagia Diet (NDD) and the International Dysphagia Diet Standardization Initiative (IDDSI). Which diets are correctly paired with an appropriate food item? (Select all that apply.)

A) NDD Level I: pudding cup
B) NDD Level II: peanut butter
C) NDD Level IV: hamburger patty
D) IDDSI level 5: loose ground beef
E) IDDSI level 7: white bread with butter
F) IDDSI level 3: milkshake

Question 20

A client in the Intensive Care Unit has 2 IV sites, a small-bore feeding tube, a bladder catheter, and 3 wound drains. What actions by the nurse are most important for this patient's safety? (Select all that apply.)

A) Empty the wound drains after providing skin care.
B) Label all tubes close to where the enter the client.
C) Trace all tubes' locations before using them.
D) Separate tubes by their function.
E) Use color-coded labels on tubes and their attachments.

Question 21

A client's NG tube is not sumping and gastric contents are visible in the blue "pigtail." What actions by the nurse are appropriate? (Select all that apply.)

A) Reposition the client.
B) Flush the NG tube with water.
C) Flush the "pigtail" with water.
D) Place the "pigtail" above the stomach.
E) Turn the suction up higher.

Question 22

After inserting a nasogastric tube, what elements does the nurse document? (Select all that apply.)

A) Size of the tube
B) Client tolerance
C) Naris chosen for placement
D) Length of exposed tube
E) Description of returns
F) Results of "swoosh" test

Question 23

A newly hired nurse is feeding a client who has a high risk for aspiration. What actions by the nurse indicate a need to review the technique? (Select all that apply.)

A) Plans a short rest period for the client prior to meals
B) Elevates the head of the bed to 45 degrees
C) Assists the client with cutting food into small pieces
D) Encourages swallowing liquids immediately after solids
E) Elevates the head of the bed for 30 minutes after the meal

Question 24

A newly admitted older client has not been eating any of the meal trays. What actions would the nurse take? (Select all that apply.)

A) Open all cartons and packages on the tray.
B) Assess for culturally appropriate foods.
C) Ask the client "Why aren't you eating?"
D) Ensure the environment is pleasant for meals.
E) Determine if the client has well-fitting dentures.

Question 25

A client is on a clear liquid diet. What foods, brought to the client by the nursing student, would indicate a need for the student to review the diet? (Select all that apply.)

A) Chicken broth
B) Orange gelatin
C) Sherbet
D) Coffee
E) Water
F) Pudding