Deck 16: Specialized Nutrition Support: Enteral and Parenteral Nutrition

Question 1

Which formula component is helpful in treating diarrhea and constipation and maintaining blood glucose levels? ​

A)glucose
B)hypertonicity
C)fiber
D)proteins
E)lipids

Answer 1

C

Question 2

Enteral nutrition includes:

A)total parenteral nutrition (TPN).
B)peripheral parenteral nutrition (PPN).
C)tube feedings.
D)simple IVs.
E)oral feedings.

Answer 2

C

Question 3

If a patient tolerates a formula after it is initiated, the rate of a continuous feeding should be increased by 30 milliliters per hour every 8 hours. ​

Answer 3

False

Question 4

Standard IV amino acid solutions contain essential amino acids but no nonessential amino acids.

Question 5

A drawback to using specialized or disease-specific formulas is that:

A)they are expensive.
B)they are not well tolerated.
C)they cause high gastric residuals.
D)they are not available for common chronic conditions.
E)they are difficult to administer.

Question 6

Enteral formulas that consist of pureed whole foods are called:

A)standard.
B)hydrolyzed.
C)blenderized.
D)modular.
E)supplemental.

Question 7

Most intestinal feedings are delivered by continuous drip. ​

Question 8

Types of formulas that contain intact proteins are called

A)disease-specific formulas.
B)hydrolyzed formulas.
C)standard formulas.
D)modular formulas.
E)supplemental formulas.

Question 9

Cyclic feedings are conducted over periods of 8 to 16 hours.

Question 10

The protein content of most standard formulas ranges from _____ of total kcalories. ​

A)5-10%
B)12-20%
C)25-30%
D)35-40%
E)45-50%

Question 11

Enteral nutrition provides nutrients to the:

A)lymphatic system.
B)gastrointestinal tract.
C)central veins.
D)peripheral veins.
E)peripheral arteries.

Question 12

Enteral nutrition is preferred over parenteral nutrition because enteral nutrition helps stimulate or maintain normal gut function. ​

Question 13

When a patient is being tube fed, he or she cannot eat food.

Question 14

Highly concentrated nutrient solutions are not suitable for peripheral parenteral nutrition. ​

Question 15

The use of PPN is not possible if a patient's peripheral veins are weak. ​

Question 16

In PPN, the osmolarity of a feeding solution is usually limited to 500 milliosmoles per liter. ​

Question 17

Which feature describes elemental formulas? ​

A)They contain intact proteins.
B)They require only minimal digestion.
C)They are given to patients who have normal digestive or absorptive functions.
D)They are produced from whole foods.
E)They are often high in fat content.

Question 18

Parenteral nutrition refers to the delivery of nutrient solutions into:

A)the mouth.
B)a vein.
C)the intestines.
D)the stomach.
E)the aorta.

Question 19

Enteral nutrition is more costly than parenteral nutrition. ​

Question 20

Modular formulas are:

A)prepared for patients who require specific nutrient combination needs.
B)prepared from whole foods.
C)general-use, complete formulas.
D)added to parenteral formulas to adjust the nutrient composition.
E)low in vitamins and minerals.

Question 21

Which feeding tube placement site would be most appropriate for a patient who is expected to be on a tube feeding for less than four weeks? ​

A)gastrostomy
B)jejunostomy
C)nasogastric
D)duodenostomy
E)nasoduodenal

Question 22

Aspirations associated with gastric feedings can lead to damage to the:

A)heart.
B)liver.
C)stomach.
D)mouth.
E)lungs.

Question 23

To prevent bacterial contamination during tube feedings, care givers must follow all of these recommendations EXCEPT:

A)use fresh formula every 48 hours.
B)store open or mixed formula in the refrigerator.
C)never add fresh formula to formula that has been hanging.
D)change the feeding container and tubing every 24 hours.
E)clean the formula lid with alcohol before opening.

Question 24

The outer diameter of a feeding tube is measured in:

A)millimeters.
B)French units.
C)milliliters.
D)English units.
E)standard units.

Question 25

Enteral formulas may be used orally to supplement a patient's diet. When this occurs, _____ becomes an important consideration. ​

A)taste
B)cost
C)osmolality
D)calorie content
E)fiber content

Question 26

An ideal formula for a patient is one that:

A)meets his/her medical and nutrient needs.
B)is the least expensive.
C)provides fiber.
D)contains lactose.
E)is easiest to administer.

Question 27

The appropriate placement site for tube feeding in an infant is:

A)nasogastric.
B)nasoduodenal.
C)orogastric.
D)nasojejunal.
E)gastrostomy.

Question 28

A "12 French" feeding tube has a diameter of:

A)2 mm.
B)4 mm.
C)6 mm.
D)8 mm.
E)12 mm.

Question 29

An adult's daily water requirement is about _____ milliliters of water per kg body weight.

A)10-20
B)20-30
C)30-40
D)40-50
E)50-60

Question 30

Estimate the daily fluid needs of a 70-year-old female who weighs 110 pounds. ​

A)850-1050 mL
B)1000-1200 mL
C)1250-1500 mL
D)1500-2000 mL
E)2000-2500 mL

Question 31

Which type of enteral formula usually has the highest osmolality? ​

A)standard formulas
B)modular formulas
C)specialized formulas
D)elemental formulas
E)macronutrient formulas

Question 32

The advantages of a closed feeding system include:

A)less likelihood of contamination.
B)lower initial cost.
C)increased nurse contact with the patient.
D)increased patient tolerance.
E)less stress on the patient's digestive system.

Question 33

Which condition does not raise a patient's water requirements? ​

A)heart disease
B)severe vomiting
C)fever
D)blood loss
E)diarrhea

Question 34

A procedure in which the stomach contents of a patient are removed by suction is called:

A)gastric decompression.
B)enterostomy.
C)gastric residuals.
D)aspiration.
E)duodenal compression.

Question 35

You are working with a patient whose ability to digest and absorb food is impaired, but whose nutrient needs are not elevated. Which formula would you select for this patient? ​

A)a standard formula
B)a micronutrient formula
C)a combination of modular formulas
D)a disease-specific formula
E)an elemental formula

Question 36

To minimize the risk of aspiration of formula in tube-fed patients, the head of the patient's bed should be elevated:

A)after administering the feeding.
B)during administration of the feeding.
C)during and for 30 minutes after administration of the feeding.
D)during and for 1 hour after administration of the feeding.
E)during and for 2 hours after administration of the feeding.

Question 37

To ensure that the stomach is emptying properly, the nurse may measure:

A)gastric residual volume.
B)feeding tube residual volume.
C)body weight after feeding.
D)urine output.
E)gastric emptying rate.

Question 38

A formula that approximates the osmolality of normal blood serum:

A)is called a hypertonic formula.
B)is referred to as an isotonic formula.
C)has an osmolality of approximately 500 milliosmoles per liter.
D)is usually a hydrolyzed formula.
E)is used only in special cases.

Question 39

Which statement does not describe feeding tubes? ​

A)They are all the same diameter.
B)They come in a variety of lengths.
C)They are soft and flexible.
D)They come with special characteristics for specific purposes.
E)They allow the administration of water or medications during feedings.

Question 40

Tube feedings are commonly used for individuals with:

A)malabsorption disorders.
B)pancreatitis.
C)severe swallowing difficulties.
D)nonfunctional GI tracts.
E)intestinal blockages.

Question 41

A critically ill and malnourished patient should receive TPN by _____ administration. ​

A)bolus
B)continuous
C)cyclic
D)intermittent
E)forced

Question 42

IV lipid emulsions:

A)provide only nonessential fatty acids.
B)are hypertonic.
C)are a diluted source of energy.
D)do not contain glycerol.
E)contain egg phospholipids.

Question 43

The osmolarity of PPN solutions is limited to _____ milliosmoles per liter because of peripheral vein sensitivity. ​

A)500
B)600
C)700
D)800
E)900

Question 44

Phelebitis may develop as a result of:

A)tube feeding intolerance.
B)refeeding syndrome.
C)peripheral parenteral nutrition.
D)the use of hypertonic formulas.
E)rotating venous access sites.

Question 45

For patients who are tube fed,

A)medications should be given by mouth when possible.
B)all medications should be crushed before placing them in the feeding tube.
C)medications should be administered only when the patient is in a prone position.
D)give all medications before flushing the feeding tube.
E)gastric residual volume is not an important consideration.

Question 46

A parenteral solution containing 500 mL of a 10% lipid emulsion would provide _____ kcalories.

A)550
B)1000
C)1500
D)1800
E)2000

Question 47

Lipid infusions must be restricted in patients with:

A)diseases that require fluid restriction.
B)hypertriglyceridemia.
C)hyperglycemia.
D)hypoglycemia.
E)hypertension.

Question 48

The amino acids in a parenteral solution provide _____ kcal per gram.

A)2
B)3.4
C)4
D)4.4
E)9.0

Question 49

The main source of energy in parenteral solutions is:

A)amino acids.
B)glucose.
C)lipid emulsions.
D)fluids and electrolytes.
E)vitamins.

Question 50

Compared to enteral nutrition, parenteral nutrition:

A)carries a greater risk of complications.
B)is less expensive initially.
C)can be used for longer periods of time.
D)requires hospitalization.
E)is not usually associated with critically ill persons.

Question 51

Dextrose monohydrate provides _____ kcal/g. ​

A)0.9
B)1.8
C)2.5
D)3.4
E)4.0

Question 52

A parenteral solution that contains dextrose, amino acids, and lipids is called a:

A)standard formula.
B)modular formula.
C)2-in-1 solution.
D)3-in-1 solution.
E)hydrolyzed solution.

Question 53

A 5% dextrose solution contains:

A)2.5 grams of dextrose monohydrate per 100 mL.
B)5 grams of dextrose monohydrate per 100 mL.
C)2.5 grams of dextrose monohydrate per liter.
D)5 grams of dextrose monohydrate per liter.
E)5 grams of dextrose monohydrate per kg body weight.

Question 54

Which medical conditions or treatments indicate the need for parenteral nutrition? ​

A)severe swallowing disorders
B)mechanical ventilation
C)extremely high nutrient needs
D)short bowel syndrome
E)gastric reflux

Question 55

TPN is indicated for each scenario EXCEPT:

A)patients who cannot be fed through the GI tract.
B)situations where long-term parenteral nutrition will be required.
C)situations where nutrient requirements are high.
D)patients who are moderately malnourished.
E)patients on fluid restrictions.

Question 56

Which substance is not a component of a parenteral solution given to patients on warfarin? ​

A)zinc
B)copper
C)iron
D)selenium
E)vitamin K ​

Question 57

Lipid emulsions that contain excessive linoleic acid may:

A)hamper immune responses.
B)minimize negative nitrogen balance.
C)spare vital protein.
D)contribute to hyperglycemia.
E)cause diarrhea.

Question 58

Candidates for PPN include patients who:

A)have fragile peripheral veins.
B)have fluid restrictions.
C)have high nutrient needs.
D)require short-term nutrition support.
E)are also candidates for TPN.

Question 59

When transitioning from tube feeding to an oral diet,

A)the formula used for the tube feedings must be given via oral feedings.
B)the tube feeding should be discontinued and an oral diet started immediately.
C)the patient should shift to an oral diet as the volume of the tube feeding is gradually decreased.
D)oral intake should be about 1/3 of estimated nutrient needs when the tube feeding is discontinued.
E)oral intake should not begin until after the tube is removed.

Question 60

One of the major causes of diarrhea that frequently accompanies tube feedings is:

A)food allergies.
B)over-hydration.
C)low osmolality of liquid medications.
D)acidity of liquid medications.
E)sorbitol-containing medications.

Question 62

Patients who do not have _____ are candidates for home enteral nutrition. ​

A)dysphagia
B)gastroparesis
C)gastric outlet obstruction
D)pancreatic conditions that cause malabsorption
E)short bowel syndrome

Question 63

Rapid changes in infusion rates of a parenteral solution can cause:

A)fluctuations in blood glucose levels.
B)diarrhea.
C)obstructions.
D)infection.
E)constipation.

Question 64

Infants diagnosed with galactosemia are given formulas that do not contain:

A)iron.
B)lactose.
C)tyrosine.
D)soy.
E)fats.

Question 67

Which complication of parenteral nutrition is catheter-related? ​

A)electrolyte imbalance
B)refeeding syndrome
C)liver disease
D)nutrient deficiency
E)air embolism

Question 70

Dietary treatment of PKU includes:

A)restriction of phenylalanine.
B)avoidance of simple sugars.
C)restriction of galactose.
D)avoidance of milk and dairy foods.
E)avoidance of high protein foods.

Question 73

An inborn error of metabolism results in the absence, deficiency, or malfunction of a(n):

A)carbohydrate.
B)lipid.
C)protein.
D)fat.
E)ATP molecule.

Question 74

A condition that may develop when a severely malnourished person is aggressively fed is called:

A)shock.
B)refeeding syndrome.
C)translocation.
D)systemic inflammatory response syndrome.
E)hyperglycemia.

Question 75

To prevent refeeding syndrome in a severely stressed individual, you would:

A)start feedings at a slow rate.
B)introduce nutrients by vein.
C)provide vitamin supplements.
D)delay enteral feedings.
E)increase feeding frequency.

Question 77

Long-term TPN may result in complications such as:

A)gallbladder disease.
B)heart disease.
C)diabetes.
D)cancer.
E)COPD.

Question 78

Lifelong adherence to dietary restrictions is recommended for individuals with PKU in order to protect _____ function. ​

A)lung
B)brain
C)muscle
D)kidney
E)pancreatic