Deck 13: Food and Nutrient Delivery: Nutrition Support

Question 1

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

Answer 1

C
As dextrose monohydrate is a molecule of glucose and water, it has a lower calorie concentration than other carbohydrates (3.4 kcal/g vs.4 kcal/g).120 g × 3.4 kcal/g = 408 kcal.Ten percent lipid emulsions provide 1.1 kcal/ml solution.Twenty percent lipid emulsions provide 2 kcal/g solution.

Question 2

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.

Answer 2

D
Generally homemade (real food) tube feedings are chosen because they offer the benefit of whole foods and can create a bond with the caretakers who are often the family.They can be less expensive if there is no reimbursement available.Only commercially prepared products are paid for through insurance and Medicare.They should not be used in immunocompromised patients and must be used with a large bore feeding tube to prevent clogging.

Question 3

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

Answer 3

A
A nasogastric tube is inserted through the nares and runs down the throat and esophagus to end in the stomach.A nasojejunal tube is inserted in the same manner, but its terminus is in the jejunum.A PEG tube is placed through the abdominal wall, so it feeds directly into the stomach.A PEJ is similar except that it feeds into the jejunum.

Question 4

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 5

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?

Question 6

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 7

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 8

A common complication of enteral tube feeding is

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

Question 9

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

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

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 12

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 13

Feeding tube diameter is measured in

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

Question 14

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%

Question 15

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

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

Question 16

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

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

Question 17

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 18

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

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

Question 19

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

Question 20

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