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NUR 155 Exam 2: Nutrition +
Electrolytes Priority Guide
Exam Structure:
Goal: Help you answer questions using priority thinking, not memorization.
Exam 2 Focus: Nutrition, fluids, electrolytes, acid–base basics, and nursing
interventions.
1) The #1 Rule of Exam 2
When you see Nutrition or Electrolytes, ask:
“What can kill the patient first?”
Priority order:
Airway → Breathing → Circulation → Neuro status → Safety
If the question asks FIRST / PRIORITY / INITIAL, you must think in this
order.
A) NUTRITION PRIORITY GUIDE
2) Oral Feeding: Aspiration Comes First
If the patient has stroke, dysphagia, weakness, confusion, or coughing:
✅ Priority nursing action:
High Fowler’s position
Swallow assessment
Small bites + slow feeding
Stop feeding if choking/coughing
Suction available
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Never prioritize “encourage eating” over aspiration prevention.
Exam clue: coughing + wet voice + difficulty swallowing = aspiration risk.
3) Tube Feeding (Enteral Nutrition): Safety Steps
Tube feeding questions are usually about aspiration and tube placement.
✅ Priority actions:
Verify placement per policy
Keep HOB elevated (30–45°)
Monitor residuals per protocol
Flush tube regularly
Watch for nausea, vomiting, abdominal distention
🚫 Never lay patient flat during feeding.
4) TPN (Parenteral Nutrition): High Risk = Infection + Glucose
TPN = nutrition through IV (often central line). Major risk: sepsis +
hyperglycemia.
✅ Priority nursing actions:
Monitor blood glucose
Strict aseptic technique
Central line infection prevention
Do not stop suddenly (risk hypoglycemia)
Exam clue: TPN = blood sugar checks + infection prevention.
5) Malnutrition = Slow Healing + Weak Immunity
Malnutrition affects:
skin integrity (pressure injuries)
infection risk
wound healing
NUR 155 Exam 2: Nutrition +
Electrolytes Priority Guide
Exam Structure:
Goal: Help you answer questions using priority thinking, not memorization.
Exam 2 Focus: Nutrition, fluids, electrolytes, acid–base basics, and nursing
interventions.
1) The #1 Rule of Exam 2
When you see Nutrition or Electrolytes, ask:
“What can kill the patient first?”
Priority order:
Airway → Breathing → Circulation → Neuro status → Safety
If the question asks FIRST / PRIORITY / INITIAL, you must think in this
order.
A) NUTRITION PRIORITY GUIDE
2) Oral Feeding: Aspiration Comes First
If the patient has stroke, dysphagia, weakness, confusion, or coughing:
✅ Priority nursing action:
High Fowler’s position
Swallow assessment
Small bites + slow feeding
Stop feeding if choking/coughing
Suction available
, 2|Page
Never prioritize “encourage eating” over aspiration prevention.
Exam clue: coughing + wet voice + difficulty swallowing = aspiration risk.
3) Tube Feeding (Enteral Nutrition): Safety Steps
Tube feeding questions are usually about aspiration and tube placement.
✅ Priority actions:
Verify placement per policy
Keep HOB elevated (30–45°)
Monitor residuals per protocol
Flush tube regularly
Watch for nausea, vomiting, abdominal distention
🚫 Never lay patient flat during feeding.
4) TPN (Parenteral Nutrition): High Risk = Infection + Glucose
TPN = nutrition through IV (often central line). Major risk: sepsis +
hyperglycemia.
✅ Priority nursing actions:
Monitor blood glucose
Strict aseptic technique
Central line infection prevention
Do not stop suddenly (risk hypoglycemia)
Exam clue: TPN = blood sugar checks + infection prevention.
5) Malnutrition = Slow Healing + Weak Immunity
Malnutrition affects:
skin integrity (pressure injuries)
infection risk
wound healing
