Question 1

When the patient has just finished receiving a tube feeding, the nurse leaves the head of the patient's bed elevated for 30 to 60 minutes after feeding in order to:

Accepted Answer

The head of the bed should be left elevated at a 30- to 90-degree angle for 30 to 60 minutes after the feeding to help reduce the risk of aspiration.

Question 2

A nurse caring for a patient with bulimia nervosa should add to the care plan to assess for:

Accepted Answer

With bulimia nervosa, along with binge eating, there is purging, fasting, and the use of laxatives. These patients may eat everything on their tray then purge by inducing themselves to vomit.

Question 3

Before any nutritional tray is delivered to a patient, the nurse has the responsibility of:

Accepted Answer

The nutritional tray should be checked against the nutritional order to be sure that the patient receives the proper nutritional. No matter who actually delivers the tray, it is the nurse who confirms the accuracy of the diet.

Question 4

An older male patient is concerned about his cholesterol laboratory report that shows an elevated high density lipoprotein (HDL) level. The nurse explains that such a report indicates that:

Accepted Answer

High density lipoprotein (HDL) is the "good" cholesterol that tends to cleanse the vessels of fatty deposits.

Question 5

The nurse is caring for a patient who has total parenteral nutrition (TPN) running finds that the infusion is behind by 200 mL. The nurse should:

Accepted Answer

The rate of a TPN is never increased because of the danger of causing hyperglycemia or circulatory overload. The discrepancy is to be documented and reported to the charge nurse or physician.

Question 6

Because of the patient's dysphagia, the nurse recommends to the physician that the patient be placed on a Level II texture level diet, which means that the food is:

Accepted Answer

Level II texture is a diet in which the food has been mechanically altered to moist, 1/4 inch pieces.

Question 7

A patient who underwent surgery has an order to begin a clear liquid diet and can be offered:

Accepted Answer

A clear liquid diet consists of foods that are liquid at room temperature and are clear, have a low residue, and are easily digested. Gelatins are part of a clear liquid diet.

Question 8

A patient who is on a low cholesterol diet verbalizes that he enjoys eating meats and does not intend to stop. The nurse's most helpful response would be, "You can enjoy your meat if you will concentrate on such meats as:

Accepted Answer

Red meat, eggs, and high-fat dairy products contain large amounts of saturated fat; poultry (such as turkey breast) and fish are low-fat items and therefore are desirable when trying to reduce serum cholesterol. Fried foods also contain extra cholesterol.

Question 9

When assisting a patient with a severe visual impairment who wishes to feed himself, the nurse could best facilitate the patient's eating by:

Accepted Answer

It is best to orient a visually impaired patient to the position of the foods on the plate by describing the plate as if it is a clock face (3 o'clock, 6 o'clock, and so on).

Question 10

The nurse takes into consideration that a patient who uses alcohol is at risk for a vitamin deficiency in:

Accepted Answer

Thiamine deficiency is often present in patients who use alcohol.

Question 11

The nurse caring for the patient receiving total parenteral nutrition (TPN) should monitor the flow rate every:

Accepted Answer

Both the IV site and the flow rate should be monitored every 4 hours and the site assessed for infection.

Question 12

A patient is scheduled to receive an intermittent tube feeding. This feeding should be allowed to flow in over how many minutes?

Accepted Answer

An intermittent feeding should take approximately 10 minutes to flow into the tube.

Question 13

The nutritional documentation that is most informative is:

Accepted Answer

Nutritional documentation should include percentage of intake and how it is tolerated.

Question 14

A patient recently started on enteral tube feedings starts complaining of nausea and having diarrhea. The best nursing action is to:

Accepted Answer

Nausea, constipation, and diarrhea are concerns following institution of tube feedings.

Question 15

A nurse positions a patient for the insertion of a nasogastric (NG) tube by:

Accepted Answer

The head of the bed should be raised and the patient asked to hyperextend his head to facilitate the passage of the NG tube.

Question 16

The nurse explains that adequate vitamin D can be acquired by:

Accepted Answer

10 to 15 minutes of sunshine exposure is sufficient to produce sufficient vitamin D for people with lighter skin

Question 17

Stopping the infusion and checking for residual volume, the nurse aspirates 250 mL of gastric contents. The nurse should next:

Accepted Answer

If the residual volume is greater than 250 mL (or per agency policy), replace the withdrawn fluids, document the residual, and notify the RN or primary care provider (promotility medications may be ordered), and delay further feeding for 1 to 2 hours if facility policy states to do so.

Question 18

An obese clinic patient who is in the latter part of the first trimester of a pregnancy asks how much weight she should gain. The nurse's best response is to say that the total weight gain should be no more than:

Accepted Answer

Total weight gain for an obese patient should be no more than 20 pounds.

Question 19

An outpatient clinic nurse assesses a blood glucose level of 75 mg/dL in a patient who has been on a low carbohydrate diet for the last 10 days. The nurse should:

Accepted Answer

Document the finding. Normal blood sugar is between 70 and 120 mg/dL.

Question 20

The nurse who is preparing to give a feeding per a nasogastric (NG) tube tests the placement of the tube most safely by:

Accepted Answer

The safest and most assured method to test for NG tube placement is to aspirate stomach contents and check fluid for pH. Using the air method is not as accurate as the stomach aspiration.

Quiz 27: Nutritional Therapy and Assisted Feeding