pharm nutrition EAQs
1
When preparing an adult formula gastrostomy tube feeding for a patient, what does the nurse know to be the most common adverse effect? <p>When preparing an adult formula gastrostomy tube feeding for a patient, what does the nurse know to be the most common adverse effect?</p> Diarrhea Gastroesophageal reflux Allergic reaction Flatulence
1
Prior to administering an enteral feeding, the nurse obtains a residual of 300 mL. What is the nurse's priority action? <p>Prior to administering an enteral feeding, the nurse obtains a residual of 300 mL. What is the nurse’s <b>priority</b> action?</p> Hold the feeding Notify the provider Administer the feeding Recheck the residual in four hours
1
Prior to each enteral feeding, how can the nurse ensure the tube has not moved and has remained in the gastrointestinal (GI) tract? <p>Prior to each enteral feeding, how can the nurse ensure the tube has not moved and has remained in the gastrointestinal (GI) tract?</p> Performing an x-ray Checking gastric residual Auscultating bowel sounds pH testing of gastric secretions
1
The health care provider has indicated that the patient requires an elemental commercial enteral feeding preparation. The nurse anticipates that the provider will order which preparation? <p>The health care provider has indicated that the patient requires an elemental commercial enteral feeding preparation. The nurse anticipates that the provider will order which preparation?</p> Criticare HN Sustacal Ensure Meritene
4
The nurse identifies that the patient has been ordered Peptamen Liquid. The nurse recognizes that Peptamen Liquid is an example of which type of commercial enteral feeding preparation? <p>The nurse identifies that the patient has been ordered Peptamen Liquid. The nurse recognizes that Peptamen Liquid is an example of which type of commercial enteral feeding preparation?</p> Blenderized Polymeric Lactose-free Elemental
4
The nurse is assessing a patient with a head injury who has swelling in the eyes and nasal bleeding. What is the preferred route of nutritional delivery to this patient? <p>The nurse is assessing a patient with a head injury who has swelling in the eyes and nasal bleeding. What is the preferred route of nutritional delivery to this patient?</p> Nasogastric nutrition Gastrostomy nutrition Central parenteral nutrition Peripheral parenteral nutrition
1,3,5
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which interventions will the nurse include in the patient's plan of care? Select all that apply. <p>The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which interventions will the nurse include in the patient's plan of care? <b>Select all that apply.</b> </p> Monitor blood glucose levels. Protect the solution from exposure to light at all times. Monitor the patient for changes in temperature. Accelerate the rate of infusion to keep the infusion on time as needed. Monitor intake and output. Keep TPN solution that is not in use at room temperature.
1
The nurse is caring for a patient who has undergone coronary artery bypass grafting (CABG). The nurse finds that the patient lacks required nutritional supplementation. What is the preferred route of nutritional delivery? <p>The nurse is caring for a patient who has undergone coronary artery bypass grafting (CABG). The nurse finds that the patient lacks required nutritional supplementation. What is the preferred route of nutritional delivery?</p> Nasogastric Gastrostomy Central parenteral nutrition Peripheral parenteral nutrition
1
The nurse is caring for a patient who is receiving nasogastric feeding. The nurse finds that the patient has developed diarrhea. The patient has no other signs and symptoms. What nursing diagnosis is appropriate for this patient? Diarrhea, related to a decreased tolerance to enteral feedings and their ingredients Nutrition, less than body requirements, related to inability to take in sufficient nutrients Nutrition, more than body weight, related to nasogastric feedings and their ingredients Diarrhea, related to infection of the gastrointestinal tract due to contamination of feedings
1
The patient is receiving a bolus feeding through a gastrostomy tube and develops diarrhea. What is a priority nursing intervention? <p>The patient is receiving a bolus feeding through a gastrostomy tube and develops diarrhea. What is a <b>priority</b> nursing intervention?</p> Slow the bolus feedings. Finish the bolus and continue to monitor the patient. Stop the feeding and administer an antispasmodic. Call the health care provider.
1
The patient receiving enteral feedings has poor skin turgor, and urinary output is 40 mL/hr. What is the nurse's first intervention? <p>The patient receiving enteral feedings has poor skin turgor, and urinary output is 40 mL/hr. What is the nurse's first intervention?</p> Assess fluid intake. Call the health care provider. Assess blood pressure. Monitor hemoglobin and hematocrit.
3
What laboratory work does the nurse anticipate the health care provider to order for a patient receiving total parenteral nutrition (TPN)? <p>What laboratory work does the nurse anticipate the health care provider to order for a patient receiving total parenteral nutrition (TPN)?</p> Uric acid Creatinine Prealbumin Liver enzymes
1
Which statement is true regarding total parenteral nutrition (TPN)? <p>Which statement is true regarding total parenteral nutrition (TPN)?</p> Metastatic cancer requires TPN. The average percentage of dextrose in TPN is 35%. The TPN solution does not allow the growth of microorganisms. TPN is the secondary method for providing complete nutrients by the parenteral route.
Subclavian vein
Which vein is used for delivering central parenteral nutrition? Brachial vein Basilic vein Subclavian vein Lateral saphenous vein
2450
A nonobese patient weighing 154 lb requires total parenteral nutrition (TPN). What is the maximum amount of daily energy recommended for the patient? Record your answer using a whole number. kcal/day
3
A nurse is caring for a patient on enteral nutrition. Which intervention by the nurse needs correction? <p>A nurse is caring for a patient on enteral nutrition. Which intervention by the nurse needs correction?</p> Diluting the enteral solution Checking the continuous route every 2 to 4 hours Determining gastric residual after enteral feeding Raising the head of the patient's bed to a 30- to 45-degree angle during feeding
1
Shortly after a central line catheter is placed, the patient complains of chest pain. The nurse notes that the patient appears pale, and the skin is cool and clammy. What complication does the nurse suspect? <p>Shortly after a central line catheter is placed, the patient complains of chest pain. The nurse notes that the patient appears pale, and the skin is cool and clammy. What complication does the nurse suspect?</p> Hemothorax Air embolism Hypervolemia Pneumothorax
3
The nurse is caring for a patient who is severely malnourished and is about to administer an initial enteral feeding. How can the nurse prevent refeeding syndrome? <p>The nurse is caring for a patient who is severely malnourished and is about to administer an initial enteral feeding. How can the nurse prevent refeeding syndrome?</p> Provide nutrition using a parenteral route Initiate the bolus feeding over 15 minutes Provide calories below maintenance needs Provide calories at minimal maintenance levels
4
The nurse is instructed to stop parenteral feeds and administer enteral nasogastric tube feeds for a patient with pancreatitis. What is the reason for changing the route of nutritional delivery? <p>The nurse is instructed to stop parenteral feeds and administer enteral nasogastric tube feeds for a patient with pancreatitis. What is the reason for changing the route of nutritional delivery?</p> To promote anabolism in the patient To reduce further inflammation of the pancreas To meet specific requirements of the body To promote digestion by promoting the release of enzymes
2
The nurse is monitoring a patient who is receiving total central parenteral nutrition (central TPN). The nurse notes that the patient has severe sweating, excessive thirst, and tachycardia. What is the immediate nursing intervention? <p>The nurse is monitoring a patient who is receiving total central parenteral nutrition (central TPN). The nurse notes that the patient has severe sweating, excessive thirst, and tachycardia. What is the immediate nursing intervention?</p> Stop the central TPN infusion. Check the patient's blood glucose level. Increase the rate and flow of central TPN infusion. Obtain an order for further investigation.
2
The nurse receives an order for an enteric-coated medication to be crushed and administered through the patient's enteral tube. What is the nurse's next action? <p>The nurse receives an order for an enteric-coated medication to be crushed and administered through the patient’s enteral tube. What is the nurse’s next action?</p> Administer the medication orally Contact the health care provider to review the order Crush the medication, and administer it through the enteral tube Dissolve the medication in water, and administer it through the enteral tube
1,4,6
What are the uses for a peripherally inserted central catheter (PICC) line for parenteral nutrition? Select all that apply. <p>What are the uses for a peripherally inserted central catheter (PICC) line for parenteral nutrition? <b>Select all that apply.</b> </p> Administration of electrolytes Obtaining laboratory samples Checking central venous pressure Administration of dextrose solutions Administration of crushed medication Administration of total parenteral nutrition (TPN)
1,2,4,5
What is the advantage of initiating enteral nutrition for a critically ill patient within 24 to 48 hours of admission? Select all that apply. <p>What is the advantage of initiating enteral nutrition for a critically ill patient within 24 to 48 hours of admission? <b>Select all that apply.</b> </p> Improved wound healing Restoration of intestinal motility Increased movement of bacteria Decreased incidence of infection Maintenance of gastrointestinal function
3
What type of enteral feeding formula is most appropriate for a patient who lacks proper digestive functioning? <p>What type of enteral feeding formula is <b>most</b> appropriate for a patient who lacks proper digestive functioning?</p> Modular Specialty Elemental Polymeric
1
When administering enteral tube feedings and medications, which practices should be avoided? <p>When administering enteral tube feedings and medications, which practices should be avoided?</p> Placing the patient on the left side. Crushing enteric coated medications prior to administration through the feeding tube. Mixing enteral medications with the feeding solution. Dissolving solid medications prior to administration through the feeding tube. Flushing the tubing before and after medication administration.
2160
A patient is receiving a nasojejunal tube feeding of liquids at the rate of 150 mL/2 hrs. The patient is also receiving 20 mL of cranberry juice and 10 mL of water with every feeding. What is the patient's total intake of fluids in a day? Record your answer using a whole number and no punctuation. mL/day
1,4
A patient on total parenteral nutrition infusion (TPN) reports cough, shortness of breath, and chest pain. What reasons does the nurse suspect to be the cause of this condition? Select all that apply. <p>A patient on total parenteral nutrition infusion (TPN) reports cough, shortness of breath, and chest pain. What reasons does the nurse suspect to be the cause of this condition? <b>Select all that apply.</b> </p> Injection port fell off Infusion of excess insulin Discontinuation of fluids abruptly Disconnection of intravenous (IV) tubing Contamination during the mixing of the solution
4
A patient receiving enteral feedings has had diarrhea over the past 24 hours. The urine is noted to be concentrated, and the 24-hour total urine output is 960 mL. What is the nurse's priority action when administering the enteral feeding? <p>A patient receiving enteral feedings has had diarrhea over the past 24 hours. The urine is noted to be concentrated, and the 24-hour total urine output is 960 mL. What is the nurse’s <b>priority</b> action when administering the enteral feeding?</p> Dilute the feeding with water Administer a lower-strength feeding Increase the enteral feeding flow rate Decrease the enteral feeding flow rate
3
A patient receiving enteral nutrition has a health care provider's order to remain supine for 48 hours. What is the safest position the patient can be in during administration of an enteral feeding? <p>A patient receiving enteral nutrition has a health care provider’s order to remain supine for 48 hours. What is the safest position the patient can be in during administration of an enteral feeding?</p> Supine On the left side On the right side With the head of the bed elevated 35 to 45 degrees
3
The nurse receives an order from the health care provider to discontinue the patient's parenteral nutrition. What is the nurse's priority action? <p>The nurse receives an order from the health care provider to discontinue the patient’s parenteral nutrition. What is the nurse’s <b>priority</b> action?</p> Discontinue the infusion, and monitor the blood glucose Decrease the infusion rate, and initiate enteral nutrition Gradually decrease the infusion rate, and monitor the blood glucose Discontinue the parenteral nutrition, and administer 10% dextrose solution
3
Which gastrointestinal route of enteral feeding delivers food directly into the stomach? Nasojejunal tube Jejunostomy tube Gastrostomy tube Nasoduodenal tube
4
Which is the major complication of enteral nutrition? Air embolism Hydrothorax Hypoglycemia Aspiration pneumonitis
2
Which method of delivery for an enteral feeding does the nurse anticipate being ordered for a critically ill patient? <p>Which method of delivery for an enteral feeding does the nurse anticipate being ordered for a critically ill patient?</p> Cyclic method Continuous feedings Intermittent by gravity Intermittent infusion bolus
1
Which route is used as an initial nutritional intervention to increase caloric intake for a patient who can swallow? <p>Which route is used as an initial nutritional intervention to increase caloric intake for a patient who can swallow?</p> Oral Enteral Parenteral Nasogastric
4
While caring for a patient on total parenteral nutrition (TPN) infusion, the nurse assesses a cough, dyspnea, and auscultated rales in the patient. Which complication does the nurse suspect? <p>While caring for a patient on total parenteral nutrition (TPN) infusion, the nurse assesses a cough, dyspnea, and auscultated rales in the patient. Which complication does the nurse suspect?</p> Air embolism Hypoglycemia Pneumothorax Fluid volume overload
1
While demonstrating nursing care of parenteral infusion, what complications of total parenteral nutrition does the nurse teach the nursing students? <p>While demonstrating nursing care of parenteral infusion, what complications of total parenteral nutrition does the nurse teach the nursing students?</p> Infection is the most serious complication associated with central parenteral infusion. Aspiration is the most serious complication associated with intravenous infusion. Slow feeding through the enteral route can result in dumping syndrome. Rebound hypoglycemia may occur if parenteral nutrition is started abruptly.
