Deck 6: Nutrition Support

Question 1

A patient has an occluded postpyloric feeding tube.Which nursing intervention is indicated?

A)Irrigate the tube with a large amount of pressure to break the clog.
B)Pull the tube and insert another.
C)Slowly attempt to irrigate the tube with warm water.
D)Use a stylet to break through the clog.

Answer 1

Slowly attempt to irrigate the tube with warm water.

Question 2

A patient was admitted to the ICU for treatment of heart failure.Which dietary regimen would the nurse provide?

A)Restricted sodium of no more than 1 g/day
B)Multiple small meals throughout the day
C)Clear liquids for the first 24 hours
D)Low-potassium foods

Answer 2

Multiple small meals throughout the day

Question 3

A patient with a body mass index (BMI)of 32 is in the intensive care unit recovering from surgery to repair an abdominal aortic aneurysm.What should be the nurse's focus regarding this patient's nutritional needs?

A)Support elevated protein needs.
B)Maintain on intravenous fluids and clear liquids.
C)Limit food and fluid intake to three mealtimes daily.
D)Begin a weight-reduction program immediately.

Answer 3

Support elevated protein needs.

Question 4

A patient who has a history of anorexia is brought to the emergency department after passing out at work.Which strategy for refeeding this patient would the nurse anticipate?

A)Immediate placement of an enteral feeding tube
B)Placement of a parenteral feeding line within 24 hours
C)Efforts to stabilize serum electrolytes prior to refeeding
D)Stabilization of BUN and creatinine prior to refeeding

Question 5

A patient receiving total parenteral nutrition has elevated serum blood urea nitrogen and serum sodium levels.The nurse would conduct additional assessment for which complication?

A)Prerenal azotemia
B)Hyperglycemia
C)Central line-associated bloodstream infection (CLABSI)
D)Hepatic dysfunction

Question 6

A patient in the intensive care unit has been NPO,taking nothing by mouth,for several days.The nurse is unable to assess bowel sounds.What should be included in the plan to support this patient's nutritional needs?

A)Maintain NPO status.
B)Prepare to assist with implementation of a large bore venous access device to support total parenteral nutrition.
C)Determine best enteral feeding approach and plan implementation.
D)Begin oral feeding with a diet as tolerated as soon as bowel sounds return.

Question 7

A patient is suspected of having an air emboli from a central venous line inserted for total parenteral nutrition.What nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Place the patient on the left side.
B)Place the patient in Trendelenburg position.
C)Occlude the catheter nearest to the entry site of the skin.
D)Notify the physician and prepare to take the patient to surgery.
E)Prepare to assist with chest tube insertion.

Question 8

The nurse is caring for a patient who sustained burns of 40% of the total body surface area.What would the nurse plan to meet this patient's nutritional needs?

A)Supply with balanced nutrients to meet current body weight needs.
B)Complete a nutritional assessment and supply with high-calorie,high-protein supplements.
C)Provide high-dose therapy of vitamins C and B.
D)Supply with high-fat and high-carbohydrate supplements.

Question 9

The nurse is caring for a patient who is comatose after a traumatic brain injury.What is important for the nurse to include when planning for this patient's nutritional needs?

A)Provide adequate calories in the form of carbohydrates and fats.
B)Ensure adequate protein intake to maintain a positive nitrogen balance.
C)Plan to implement parenteral nutrition as soon as possible.
D)Increase dietary supply of cortisol.

Question 10

The nurse is planning a refeeding program for a patient diagnosed with cachexia from AIDS.Which nursing interventions are indicated?

A)Encourage the patient to eat as much as possible during each meal.
B)Initiate feeding as half of goal rate.
C)Limit the patient's intake of fluids so to encourage a normal appetite.
D)Establish baseline phosphorus,potassium,and magnesium levels.

Question 11

A patient has been started on tube feeding by nasogastric tube.When his wife visits,she says,"I need to tell you that my husband is lactose intolerant so that feeding will make him sick." What nursing response is indicated?

A)"Even though the tube feeding fluid looks like milk it is lactose-free."
B)"We did not know that.I will contact his physician immediately."
C)"Since he is being fed by tube,the fact that he is lactose intolerant is not an issue."
D)"We will watch to see if he has any symptoms of lactose intolerance."

Question 12

The nurse is caring for a patient with a history of hypercapnea.What should the nurse include when planning for this patient's nutritional needs?

A)Monitor carbohydrate intake to reduce body carbon dioxide levels.
B)Encourage fat intake.
C)Minimize vitamin supplements.
D)Limit protein.

Question 13

The nurse is assessing a patient's ability to receive enteral feedings.Which findings would the nurse evaluate as potential contraindications to this intervention? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has a history of Crohn's disease.
B)The patient has a gastric ulcer.
C)There is a mechanical obstruction.
D)The patient has developed hemorrhagic pancreatitis.
E)The patient has had severe intractable diarrhea for 3 days.

Question 14

A patient,with a history of aspiration pneumonia,is going to receive enteral feedings.What nursing interventions should be implemented?

A)Add a bit of food coloring to the bag of enteral feeding to help assess for aspiration.
B)Use a chlorhexidine mouth rinse during oral care.
C)Position the head of the patient's bed at 30 degrees.
D)Avoid suctioning the patient while feedings are in progress.

Question 15

A patient is admitted to the intensive care unit with hepatic failure.The nurse would encourage the patient to eat which item from the provided lunch?

A)Whole milk
B)Pasta with tomato sauce
C)Salad with oil and vinegar dressing
D)Mixed fruit with whipped cream

Question 16

After the insertion of a central venous catheter for total parenteral nutrition,the patient demonstrates dyspnea.The nurse is concerned that pneumothorax may be occurring.Which assessment findings would support this concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Restlessness
B)Chest pain
C)Decrease in pulse oximetry reading
D)Severe headache
E)Combativeness

Question 17

The nurse is caring for a patient with a central venous catheter for total parenteral nutrition.Which findings would indicate to the nurse that the patient might be experiencing central line-associated bloodstream infection (CLABSI)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Sudden glucose intolerance
B)Leukocytosis
C)Sudden onset of chills
D)Sudden onset chest pain
E)Tenderness at the insertion site

Question 18

The nurse is caring for a patient diagnosed with chronic renal failure.The patient is not on dialysis and currently weighs 100 kg.What would be an appropriate intake of protein for this patient?

A)120 g per day
B)50 g per day
C)240 g per day
D)60 g per day

Question 19

A newly employed nurse reports that a patient receiving nasogastric tube feedings has a gastric residual volume of 450 mL.Which nursing intervention is indicated?

A)Hold the tube feeding until the gastric aspirate is less than 100 mL.
B)Provide the tube feeding as a bolus.
C)Continue the feeding but increase assessment for intolerance.
D)Reposition the enteral tube.

Question 20

The nurse is concerned that refeeding syndrome may be occurring in a patient receiving enteral nutrition.Which laboratory values would support this concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Serum potassium is 3.4 mEq/L
B)Fasting blood glucose is 98 mg/dL
C)Hemoglobin is 10.8 g/100 mL
D)Serum sodium of 138 mEq/L
E)Chloride of 98 mmol/L