Nokea
A patient with a partial bowel obstruction will be given a 1-week course of enteral tube feeding via a nasogastric tube. Which formulation is appropriate for this patient?
- A. An elemental formulation
- B. A polymeric formulation
- C. A formulation for impaired glucose tolerance
- D. A modular formulation that contains carbohydrates
Correct Answer: A
Rationale: Elemental formulations are enteral supplements that require minimal digestion and are indicated for patients with pancreatitis, partial bowel obstruction, irritable bowel disease, and other problems. The other options are incorrect.
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An older adult patient needs to receive an enteral supplement to improve her overall nutritional status. When considering enteral supplements, the nurse notes that which formulation provides complex nutrients?
- A. Ensure Plus
- B. Moducal
- C. ProMod
- D. Microlipid
Correct Answer: A
Rationale: Ensure Plus is a polymeric formulation that contains complex nutrients, including proteins, carbohydrates, and fats. Moducal provides carbohydrates only; ProMod is a protein formulation, and Microlipid supplies only fats.
A patient has been receiving total parenteral nutrition. Upon assessment, the nurse notes these assessment findings: blood pressure 160/98 mm Hg (elevated from previous readings); pulse rate 110 beats/min and weak; pitting edema on both ankles; and new-onset confusion. The nurse suspects that the patient is experiencing which condition?
- A. Infection
- B. Hypoglycemia
- C. Hyperglycemia
- D. Fluid overload
Correct Answer: D
Rationale: Fluid overload may occur with parenteral nutrition. It is manifested by weak pulse, hypertension, tachycardia, confusion, decreased urine output, and pitting edema.
During the night shift, a patient's total parenteral nutrition (TPN) infusion ran out, and the nurse discovered that there was no TPN solution on hand to continue the infusion. The pharmacy is closed and will not reopen for 5 hours. The nurse will have to implement measures to prevent which consequence of abruptly discontinuing TPN infusions?
- A. Dehydration
- B. Hyperglycemia
- C. Dumping syndrome
- D. Rebound hypoglycemia
Correct Answer: D
Rationale: Rebound hypoglycemia may occur if TPN is discontinued abruptly. It may be prevented by infusion of 5% to 10% glucose in situations in which TPN must be stopped abruptly. The other options are incorrect.
The peripheral parenteral nutrition bag that has been infusing into the patient is empty, and the nurse realizes that the next bag is not ready. The nurse should immediately hang which of these intravenous solutions until the new bag arrives?
- A. 10% dextrose in water
- B. 20% dextrose in water
- C. 0.9% sodium chloride
- D. Lactated Ringer's solution
Correct Answer: A
Rationale: If intravenous parenteral nutrition is discontinued abruptly, rebound hypoglycemia may occur. This can be prevented with infusion of 5% to 10% glucose until the parenteral nutrition infusion is ready. For peripheral infusions, the dextrose must not be more than 10%.
A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy?
- A. Central total parenteral nutrition
- B. Peripheral parenteral nutrition
- C. Oral nutritional supplements with meals
- D. Nasogastric enteral supplementation
Correct Answer: B
Rationale: Peripheral parenteral nutrition is indicated for anorexia caused by radiation or cancer chemotherapy. Total parenteral nutrition is indicated for more long-term use. The other options are incorrect.