Deck 16: Specialized Nutrition Support - Enteral and Parenteral Nutrition

Question 1

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%

Answer 1

B

Question 2

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

Answer 2

B

Question 3

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

Answer 3

True

Question 4

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

Question 5

Modular formulas are _____.​

A) ​prepared for patients who require specific nutrient combinations
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 6

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 7

Enteral nutrition provides nutrients to the _____.​

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

Question 8

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

Question 9

Enteral nutrition is more costly than parenteral nutrition.​

Question 10

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

Question 11

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 12

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 13

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 14

Enteral nutrition includes _____.

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

Question 15

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

Question 16

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

Question 17

Enteral formulas that consist of pureed whole foods are called ______.​

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

Question 18

Most intestinal feedings are delivered by continuous drip.​

Question 19

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

Question 20

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

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

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 23

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 24

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 25

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 26

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 27

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

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

Question 28

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 29

Aspirations associated with gastric feedings can lead to damage to the _____.​

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

Question 30

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 31

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 32

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 33

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 34

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 35

The outer diameter of a feeding tube is measured in _____.​

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

Question 36

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 37

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 38

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 39

The appropriate placement site for tube feeding in an infant is _____.​

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

Question 40

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 41

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 42

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 43

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

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

Question 44

Lipid infusions must be restricted in patients with _____.​

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

Question 45

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 46

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 47

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 48

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 49

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 50

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 51

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 52

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 53

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 54

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 55

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 56

Dextrose monohydrate provides _____ kcal/g.​

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

Question 57

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 58

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 59

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 60

The main source of energy in parenteral solutions is _____.​

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

Question 61

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
isotonic formula

Question 62

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
enteral nutrition

Question 63

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 64

Infants diagnosed with galactosemia are given formulas that do not contain _____.​

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

Question 65

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 66

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
modular formulas

Question 67

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
elemental formulas

Question 68

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 69

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 70

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
osmolality​

Question 71

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
medium-chain triglycerides

Question 72

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
nutrition support

Question 73

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
hypertonic formula

Question 74

Which complication of parenteral nutrition is catheter-related?​

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

Question 75

Long-term TPN may result in complications such as _____.​

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

Question 76

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
specialized formulas

Question 77

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 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

Question 79

Matching
a. the delivery of formulated nutrients by feeding tube or intravenous infusion
b. the provision of nutrients using the GI tract, including the use of tube feedings and oral diets
c. general-purpose enteral formulas that contain mostly intact proteins and polysaccharides
d. enteral formulas that are made by blenderizing whole foods
e. enteral formulas that contain macronutrients that have been partially or fully hydrolyzed
f. triglycerides that contain fatty acids that are 8 to 10 carbons in length, do not require digestion, and can be absorbed in the absence of lipase or bile
g. enteral formulas designed to meet the nutrient needs of patients with specific illnesses
h. enteral formulas that contain only one or two macronutrients; used to enhance other formulas
i. a formula with an osmolality similar to that of blood serum (300 mOsm/kg)
j. a formula with an osmolality greater than that of blood serum
k. the osmotic property of a solution, based on its concentrations of molecules and ionic particles
blenderized formulas

Question 80

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