Deck 16: Specialized Nutrition Support: Enteral and Parenteral Nutrition

Question 1

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

Answer 1

False

Question 2

Parenteral nutrition is usually reserved for patients who cannot meet their nutrient needs using the enteral route.

Answer 2

True

Question 3

Any drug-nutrient interaction that occurs between conventional foods and drugs can occur between formulas and drugs as well.

Answer 3

True

Question 4

Most intestinal feedings are delivered by continuous drip.

Question 5

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

Question 6

Complications of tube feedings can be gastrointestinal, mechanical, or metabolic in nature.

Question 7

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

Question 8

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

Question 9

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.

Question 10

One method of making the transition from an intravenous feeding to an oral diet is to place the patient on a tube feeding.

Question 11

Enteral nutrition includes:

A)TPN.
B)PPN.
C)tube feedings.
D)simple IVs.

Question 12

Once the need for intravenous nutrition has resolved, the patient should be immediately taken off of the solution and put onto an oral diet.

Question 13

Low-profile gastrostomy tubes are often preferred by active children and adults because they allow these individuals to lead a more normal lifestyle.

Question 14

The cost of home nutrition support is a concern for people who require it.

Question 15

A patient's appetite may remain suppressed for several weeks after parenteral nutrition is terminated.

Question 16

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

Question 17

Enteral nutrition provides nutrients using:

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

Question 18

Enteral nutrition is more costly than parenteral nutrition.

Question 19

Patients undergoing severe metabolic stress may develop hyperglycemia, which is a common complication associated with TPN.

Question 20

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

Question 21

outer diameter of a feeding tube is measured in:

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

Question 22

of the following are characteristics of elemental formulas except:

A)they contain broken-down molecules of protein.
B)they require only minimal digestion.
C)they are used for patients who have compromised digestive or absorptive functions.
D)they are recommended for patients who are able to digest and absorb nutrients without difficulty.

Question 23

of the following are characteristics of feeding tubes except:

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.

Question 24

appropriate placement of a tube feeding in an infant is:

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

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

Question 26

Standard formulas provide approximately:

A)0.5 kcalories per mL.
B)1 kcalorie per mL.
C)1.5 kcalories per mL.
D)2 kcalories per mL.

Question 27

drawback to using specialized or disease-specific formulas is:

A)they are expensive.
B)patients do not tolerate them well.
C)they cause high gastric residuals.
D)they are not available for common chronic conditions.

Question 28

Which of the following statements about modular formulas is false? Modular formulas:

A)are prepared for patients who require specific nutrient combinations.
B)are created from individual macronutrients.
C)are general-use, complete formulas.
D)may be added to other enteral formulas to adjust the nutrient composition.

Question 29

feedings are commonly used for individuals with:

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

Question 30

"12 French" feeding tube has a diameter of:

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

Question 31

are working with a patient whose ability to digest and absorb food is impaired, but whose nutrient needs are not elevated.Which of the following formulas would you select?

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

Question 32

Parenteral nutrition refers to the delivery of nutrient solutions into:

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

Question 33

Fiber in an enteral formula provides all of the following benefits except:

A)normalizing intestinal function.
B)helping to treat diarrhea and constipation.
C)increasing the caloric content of the formula.
D)assisting with blood glucose control.

Question 34

Which of the following feeding tube placement sites would be the most appropriate for a patient who is expected to be on a tube feeding for less than 4 weeks?

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

Question 35

Aspiration is a risk for all of the following except:

A)patients with esophageal disorders.
B)patients with neuromuscular diseases.
C)patients who are unconscious.
D)patients with renal disease.

Question 36

Enteral formulas that consist of pureed whole foods are called:

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

Question 37

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.

Question 38

Which type of enteral formula usually has the highest osmolality?

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

Question 39

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.

Question 40

Types of formulas that contain intact proteins are called:

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

Question 41

Which of the following medical conditions or treatments indicates the need for TPN?

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

Question 42

Dextrose monohydrate provides _____ kcal/g.

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

Question 43

Candidates for peripheral parenteral nutrition include patients who:

A)have fragile peripheral veins.
B)have fluid restrictions.
C)have high nutrient needs.
D)require short-term nutrition support.

Question 44

Which of the following statements regarding transitioning from tube feeding to an oral diet is correct?

A)The patient must begin the transition by orally consuming the formula they have been receiving as via tube feeding.
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.

Question 45

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.

Question 46

TPN is indicated for each of the following 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.

Question 47

Before discontinuing a tube feeding, the patient's oral intake should be about _____ of estimated nutrient needs.

A)1/3
B)½
C)¾
D)2/3

Question 48

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.

Question 49

of the following are ways to prevent bacterial contamination of tube feedings except:

A)using fresh formula every 48 hours.
B)storing open or mixed formula in the refrigerator.
C)never adding fresh formula to formula that has been hanging.
D)changing the feeding container and tubing every 24 hours.

Question 50

Phelebitis may develop as a result of:

A)tube feeding intolerance.
B)refeeding syndrome.
C)peripheral parenteral nutrition.
D)the use of hypertonic formulas.

Question 51

Compared to enteral nutrition, parenteral nutrition:

A)carries a greater risk of complications.
B)is less expensive.
C)can be used for longer periods of time.
D)requires hospitalization.

Question 52

main source of energy in parenteral solutions is:

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

Question 53

Which of the following conditions does not raise a patient's water requirements?

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

Question 54

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.

Question 55

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

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

Question 56

Which of the following statements is true regarding the administration of medications to 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)Place the patient in a prone position before administering medications.
D)Give all medications before flushing the feeding tube.

Question 57

adult's requirement for water is about:

A)1000 mL/day.
B)1500 mL/day.
C)2000 mL/day.
D)2500 mL/day.

Question 58

Delivering 250 to 500 milliliters of formula in less than 20 minutes is referred to as:

A)a bolus feeding.
B)a continuous drip feeding.
C)an intermittent feeding.
D)a slow drip feeding.

Question 59

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.

Question 60

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

Question 61

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

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

Question 62

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.

Question 63

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
Mr.Avery's feeding is being delivered continuously by an infusion pump.The advantage of a continuous feeding is:

A)an accurate and steady flow rate.
B)less expense.
C)more freedom of movement for the patient.
D)less risk of diarrhea.

Question 64

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.

Question 65

All of the following are criteria for the selection of candidates for home parenteral and enteral nutrition except:

A)the cleanliness of the home environment.
B)the patient's financial resources.
C)the ability of the patient or caregiver to learn the necessary procedures.
D)the patient's expected lifespan.

Question 66

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.

Question 67

many kcalories would a patient receive from an IV solution containing 1000 mL of 50 percent dextrose and 1200 mL of 7 percent amino acid solution?

A)1785
B)1942
C)2036
D)2124

Question 68

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.

Question 69

appropriate method for administering TPN to a critically ill and malnourished patient is:

A)bolus.
B)continuous.
C)cyclic.
D)as needed.

Question 70

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
Avery's swallowing ability and oral intake are improving.He is now consuming about 2/3 of his estimated nutrient needs from oral intake.It would be appropriate at this time to:

A)discontinue the tube feeding.
B)increase the rate of the tube feeding.
C)decrease the rate of the parenteral feeding.
D)discontinue the parenteral feeding.

Question 71

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
59.In the absence of any pre-existing medical problems or problems with digestion and absorption, the type of enteral formula that would be most appropriate for Mr.Avery is a(n):

A)standard formula.
B)elemental formula.
C)specialized formula.
D)3-in-1 solution.

Question 72

Which of the following trace minerals is not included in a parenteral solution?

A)zinc
B)copper
C)iron
D)selenium

Question 73

Parenteral nutrition can be discontinued when _____ of estimated energy needs are being met by oral intake, tube feeding, or a combination of the two.

A)1/3-1/2
B)1/4-1/3
C)1/3-3/4
D)2/3-3/4

Question 74

of the following are true statements concerning IV lipid emulsions except that:

A)they provide essential fatty acids.
B)they are hypertonic.
C)they are a concentrated source of energy.
D)they are isotonic.

Question 75

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
Mr.Avery's physician is hopeful that his swallowing ability will improve in the coming weeks.Which feeding route would be most appropriate for Mr.Avery at this time?

A)orogastric
B)nasojejunal
C)nasogastric
D)parenteral

Question 76

Lipid infusions must be restricted in patients with:

A)diseases that require fluid restriction.
B)hypertriglyceridemia.
C)hyperglycemia.
D)hyperkalemia.

Question 77

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
Which form of nutrition support is appropriate for Mr.Avery at this time?

A)total parenteral nutrition
B)tube feeding
C)oral enteral supplement
D)peripheral parenteral nutrition

Question 78

parenteral solution containing 500 mL of a 20% lipid emulsion would provide _____ kcalories from lipids.

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

Question 79

Long-term TPN may result in complications such as:

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

Question 80

Case Study Questions
Use the following case study to answer questions
Mr.Avery is a 77-year-old retired engineer.He is 5'10" tall and weighs 171 pounds.He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time.
After two weeks, Mr.Avery is moved to a rehab facility.It would be appropriate at this time to change his feeding method to:

A)total parenteral nutrition.
B)an intermittent feeding.
C)an oral supplement.
D)peripheral parenteral nutrition.