Introduction To Critical Care Nursing 7Th Edition Test Bank

TEST BANK INTRODUCTION TO
CRITICAL CARE NURSING 7TH EDITION
Chapter06:NutritionalTherapy - ANS



1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteraltubefeedingsare
notpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorcomplicationsforthistherapy -
ANS b. Fluidandelectrolyteimbalancesandsepsis



.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement? - ANS d.
Topreventaspirationofthefeedings



3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterinsertion? - ANS
d. Subclavianvein



4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,thepatientisplac
edonenteralfeedings.Followingplacementofanasogastrictubefortubefeeding,whatisthenextcriticalstep? -
ANS c. Obtainachestradiograph.



5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflowtubefeeding.T
henurseknowsthatthisapproachwaschosenbecause: - ANS c.
theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves



6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryoutwhichinterve
ntiontominimizeaspirationrisk? - ANS Elevatetheheadofthebed30degrees.



7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfluid.Thisisaconc
ernbecausethismostlikelydemonstratesthatthepatienthas: - ANS d. tube feeding intolerance.

,8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenurseholdsthetube
feeding,whichhadbeeninfusingat100mL/hr.Thenurseknowsthatthenextactionshouldbe: - ANS d.
recheck the residual in 2hours



9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - ANS a.
Abdominal distention



10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Astoolspecimenisco
llectedtocheckforwhichpossiblecause? - ANS a. Clostridium difficile



11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpossibleinterven
tionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingtheplanofcare? - ANS b.
Infuseantibioticsthroughtheintravenousline.



12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensitiveindicatorofp
roteinsynthesisandcatabolism? - ANS c. Prealbumin



13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions? - ANS d. Phenytoin



14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - ANS d. Without
nutritional stimulation, mucosal villi atrophy.



15.An important nutritional consideration in the elderly population is: - ANS c. potential for drug-
nutrient interaction related to polypharmacy.



16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - ANS d. weight loss,
elevated glucose, and dehydration

,17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best
initiated within what time frame following the injury? - ANS a. 24hours



18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunitonaventilator.T
henutritionassessmentnotesthatthepatienthasaproteinandvitamindeficiencyandisunderweight.Whichfor
mulafornutritionalassessmentismostappropriate? - ANS b. Fiber-addedformula



19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutritionaltherapy -
ANS d. Gut mucosa is preserved.



20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? - ANS b. The patient with
ileitis



21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - ANS b.
flushthetubeevery4hourswith20to30mLoftapwater.



22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto: - ANS c.
35kcal/kg/day



23.Malnutritioncontributestoinfectionriskby - ANS b. impairing immune function



24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - ANS d.
stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph.



1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) - ANS a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.

d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,andfats.

, 2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?(Selectallthatapply). - ANS b.
Changethetubingevery24hours.

d. Monitortriglyceridelevels.



3.Calorie-densefeedings:(Selectallthatapply.) - ANS a. are most useful in heart failure and liver disease.



4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - ANS b. elevatedbloodsugar.

c. infectionatthecathetersite.

d. volumeoverload.



5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?(Selectallthatapply.) - ANS
a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.

b. Insulinmaybeaddedtoaparenteralnutritionsolution.

c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition.



Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ - ANS
A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph.
E.Assessresiduals. ANS: B,D,C,A,E



1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivecareunitatnoon.
Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevels:

pH7.31

PaCO248mmHg

Bicarbonate22mEq/L

PaO2115mmHg

O2saturation99% - ANS d. Uncompensated

respiratory