Deck 27: Nutritional Therapy and Assisted Feeding

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:

A) facilitate stomach emptying and prevent aspiration.
B) maintain skin integrity to the buttocks.
C) facilitate lung drainage and promote ventilation.
D) prevent feeding tube from clogging.

Answer 1

facilitate stomach emptying and prevent aspiration.

Question 2

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

A) hiding food in napkins or under plate.
B) inducing self to vomit.
C) refusing to eat.
D) flushing food down commode.

Answer 2

inducing self to vomit.

Question 3

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

A) determining if the patient needs assistance to eat.
B) confirming the diet on the tray with the diet sheet.
C) evaluating if the food is of the appropriate temperature.
D) adding extra salt and sugar packets.

Answer 3

confirming the diet on the tray with the diet sheet.

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:

A) he should go on a strenuous low cholesterol diet.
B) he is at risk for hypertension.
C) is developing atherosclerosis.
D) his vessels are being cleansed 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:

A) increase the flow rate 5% until the infusion has caught up.
B) check the patient's stomach residual volume.
C) elevate the head of the bed 30 degrees.
D) document the discrepancy and report to the charge nurse.

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:

A) thickened to prevent aspiration.
B) pureed to a pudding consistency.
C) mechanically altered, moist, minced helpings.
D) minced into bite size pieces.

Question 7

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

A) tea with milk.
B) Jell O.
C) cream soup.
D) fruit sherbet.

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:

A) broiled sirloin steak."
B) fried catfish."
C) baked turkey breast."
D) sausage patties."

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:

A) placing the plate on his lap.
B) seating the patient in a chair and placing over-the-bed table appropriately.
C) orienting the patient to the position of foods on the plate using a clock face description.
D) placing each food in a separate container or bowl.

Question 10

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

A) thiamine.
B) cyanocobalamin.
C) ascorbic acid.
D) iron.

Question 11

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

A) 2 hours.
B) 3 hours.
C) 4 hours.
D) 6 hours.

Question 12

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

A) 1 minute
B) 2 minutes
C) 5 minutes
D) 10 minutes

Question 13

The nutritional documentation that is most informative is:

A) ate all of lunch.
B) ate 50% of lunch without difficulty. Refused all solid food.
C) drank most of liquids without difficulty.
D) assisted feeding liquid diet, choked frequently.

Question 14

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

A) check the enteral tube for placement.
B) slow down the feedings and monitor.
C) perform a fingerstick blood glucose test.
D) stop the feedings and inform the physician.

Question 15

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

A) turning the patient to a right side lying position.
B) sitting the patient upright and hyperextending the patient's head.
C) lowering the head of the bed to a flat position.
D) raising the head of the bed to 30 degrees.

Question 16

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

A) eating 2 oranges a day every week.
B) eating fish 3 times a week.
C) having 10 to 15 minutes of sunshine exposure per day.
D) eating green leafy vegetables.

Question 17

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

A) replace the aspirate and continue with the feeding.
B) throw the aspirate away and flush the tubing.
C) replace the aspirate and delay feeding for 1 to 2 hours.
D) throw the aspirate away and delay feeding for 2 hours.

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:

A) 35 pounds.
B) 30 pounds.
C) 20 pounds.
D) 10 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:

A) notify the physician about the ineffectiveness of the diet.
B) document the finding.
C) suggest a moderate increase carbohydrate intake.
D) arrange a dietician consultation to discuss a more effective diet.

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:

A) checking the lungs for rhonchi.
B) instilling 10 mL of sterile water and checking for cough.
C) aspirating stomach contents.
D) injecting 20 mL of air and listen at the tip of the xiphoid.

Question 21

A nurse caring for a patient diagnosed with AIDS would include in the nutritional plan of care: (Select all that apply.)

A) asking the patient about sexual history.
B) encouraging the patient to eat solid foods that are high in protein.
C) offering the patient supplements such as Ensure.
D) obtaining an order for a dietitian consult.
E) urging the patient to eat three well-balanced meals per day.
F) offering pureed foods when the patient's mouth is painful.

Question 22

The nurse caring for a patient receiving enteral feedings would assess for tolerance of the feeding by monitoring:

A) for gastric tube patency.
B) for duodenal tube patency.
C) for abdominal distention.
D) the rate of the feeding.

Question 23

The nurse suggests to a diabetic patient to eat complex carbohydrates, which include: (Select all that apply.)

A) whole grain foods.
B) brown rice.
C) lima beans.
D) legumes.
E) sweet potatoes.

Question 24

The nurse inserting an NG tube through the nostril into the back of the throat of a patient would instruct the patient to:

A) hyperextend the head.
B) cough forcefully.
C) drop head forward and begin to swallow.
D) open mouth and extend tongue.

Question 25

A nurse is instructing a family member who will be caring for a patient receiving enteral feedings after discharge to home. The nurse would emphasize:

A) taping the gastrostomy tube so that it does not hang lower than the stomach.
B) discarding unused opened refrigerated formula after 3 to 4 days.
C) administering tube feedings while they are still cold from the refrigerator.
D) mixing all medications together for administration at the same time.

Question 26

Fluid overload is suspected in an 82-year-old patient who is receiving total parenteral nutritional (TPN) therapy when the nurse assesses: (Select all that apply.)

A) excessive urine output.
B) increased pulse rate.
C) dyspnea.
D) hyperactive bowel sounds.
E) complaint of headache.

Question 27

While the nurse is explaining the procedure for inserting a tube for enteral feedings, the patient interrupts and asks why there is a need for this tube. The nurse's best response is:

A) "Your physician has ordered this to help your condition."
B) "Tell me what your primary care provider told you about this procedure."
C) "Are you telling me you don't want this tube inserted?"
D) "This tube placement will only be temporary."

Question 28

The correct anatomic landmarks to follow when inserting a nasogastric tube is to measure from the _______________ to the ________________ and then to the ________________.

Question 29

The nurse takes into consideration that excessive intake of saturated and trans fat leads to the development of fatty deposits being laid down in the walls of the blood vessels and causing ____________.

Question 30

The nurse counsels the bulimic patient that her eating disorder can lead to serious conditions such as: (Select all that apply.)

A) esophageal ulcers.
B) diverticulitis.
C) ulcerative colitis.
D) peptic ulcers.
E) heart failure.

Question 31

When caring for a patient receiving total parenteral nutrition, the nurse knows that it is essential to:

A) check the flow rate every shift.
B) order electrolytes daily.
C) monitor IV site every shift.
D) monitor the blood glucose.

Question 32

When the patient complains about the insertion of the total parenteral nutrition (TPN) tube interfering with his movement, the nurse explains that the insertion in the subclavian vein allows: (Select all that apply.)

A) adequate dilution of TPN solution.
B) closer proximity to the heart.
C) more effective monitoring from the IV pump.
D) for adequate blood flow.
E) for more ease in dressing insertion site.

Question 33

The nurse recommends to a patient who desires weight reduction to engage in a minimum of ______ minutes of exercise most days of the week.

Question 34

A patient has a new order to have an NG tube removed. The nurse should initially:

A) wash her hands and apply clean gloves.
B) encourage mouth care as needed.
C) explain the procedure to the patient.
D) pinch the tube while removing it.

Question 35

A nurse giving a bolus feeding through a nasogastric tube with a syringe would: (Select all that apply.)

A) pull up 50 mL of formula in the syringe.
B) lower the head of the bed to flat position.
C) allow feeding to flow in by gravity.
D) flush the tube with 50 mL of water.
E) check the position of the tube.

Question 36

A nurse instructs a patient who is to receive a soft diet that the diet will include: (Select all that apply.)

A) eggs.
B) multigrain bread.
C) baked potato.
D) soups.
E) fruit juices.
F) milk products.