Chapter 17: Nutritional Support

Chapter 17: Nutritional Support

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is preparing to administer enteral nutrition to a patient. Which assessment finding would prompt the nurse to hold the nutrition and notify the patient’s provider?

a.	Blood pressure of 90/60 mm Hg
b.	Decreased bowel sounds
c.	A productive cough
d.	A temperature of 37.8° C

 

 

ANS:  B

Enteral nutrition requires adequate small bowel function with digestion, absorption, and gastrointestinal motility. The nurse should assess for abdominal distension and a decrease or absence of bowel sounds. Patients may still receive enteral feedings if hypotension, cough, or elevated temperature are present.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 244

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

2. The nurse is preparing to administer an enteral feeding to a patient who receives 300 mL of Isocal over 30 minutes every 4 hours. The nurse checks the residual prior to initiating the feeding and notes a residual amount of 50 mL of formula. Which action will the nurse take next?

a.	Administer the feeding as ordered.
b.	Administer the feeding over 60 minutes.
c.	Hold the feeding and notify the patient’s provider.
d.	Wait 1 hour and recheck the residual again.

 

 

ANS:  A

The nurse should determine gastric residual before each feeding when patients are receiving intermittent feedings. A residual greater than 50% of a previous feeding indicates delayed gastric emptying and warrants notifying the provider. This patient has a residual less than 50%, so the nurse may proceed with the next feeding. A residual of 50 mL is significant in patients receiving continuous enteral feedings. The nurse cannot change the rate of an enteral infusion without an order from the provider.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 247

TOP:   NURSING PROCESS: Nursing Intervention/Evaluation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

3. The provider calculates the enteral nutrition needs for a nonambulatory patient and determines that the patient will need 300 mL of Ultracal every 4 hours. Which method of delivery will the nurse use to administer these feedings?

a.	300 mL every 4 hours given via syringe as a 10-minute bolus
b.	300 mL every 4 hours given via enteral pump as a 45-minute infusion
c.	75 mL per hour via enteral pump as a continuous infusion
d.	150 mL every 2 hours via gravity infusion

 

 

ANS:  B

Intermittent enteral feedings are an inexpensive and safe method of administering enteral nutrition and may be used when patients are nonambulatory. Three hundred to 400 mL of solution may be given and should infuse over 30 to 60 minutes. While bolus methods may be used for patients receiving 250 to 400 mL of solution, this method is not tolerated well by non-ambulatory patients and may cause nausea, vomiting, aspiration, abdominal cramping, and diarrhea. Continuous feedings are used for critically ill patients. Gravity feedings cannot be well-controlled and may infuse too fast or too slow.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Pages 245-246

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

4. The nurse is preparing a patient who will receive intermittent enteral nutrition at home with a hyperosmolar solution. What information will the nurse include when teaching this patient?

a.	How to perform the Valsalva maneuver
b.	The need to consume extra fluids between feedings
c.	The need to decrease dietary fiber
d.	The need to remain supine during infusion of the enteral solution

 

 

ANS:  B

Dehydration can occur if patients do not receive enough water during or between feedings, so patients should be taught to consume extra water. The Valsalva maneuver is taught to patients who receive TPN to prevent embolus. Enteral feedings can cause diarrhea, so decreased fiber may aggravate that.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 246

TOP:   NURSING PROCESS: Nursing Intervention: Patient Education

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition