ASPEN CNSC EXAMINATION TEST 2026 Q&A
WITH CORRECT ANSWERS GRADED A+
◍ Why would concentrated enteral solutions not be recommended for
nausea/vomiting? Answer: Concentrated enteral solutions generally
contain more fat and can contribute to enteral intolerance by
presenting a higher osmotic load to the GI tract. They also slow
gastric emptying.
◍ The initiation of enteral tube feeding should be delayed when the
patient is
1. hemodynamically unstable
2. at a decreased level of consciousness
3. without bowel sounds
4. scheduled for discharge Answer: 1. hemodynamically unstable
◍ EN should be delayed until these 3 things can be accomplished in
order to reduce the risk of intestinal ischemia? Answer: 1. patient is
fully volume resuscitated
2. hemodynamically stable
3. mesenteric perfusion has been restored
◍ Is evidence of bowel function (bowel sounds) required prior to
starting enteral nutrition? Answer: No
,◍ What is the evidence for not withholding EN until patient is fully
volume resuscitated, hemodynamically stable and mesenteric
perfusion has been restored? Answer: A recent retrospective trial
indicates early EN in hemodynamically unstable patients receiving
mechanical ventilation may decrease mortality; however, due to
inherent study limitations further prospective randomized trials are
needed before guideline changes can be made
◍ When initiating and advancing enteral feedings in the hospitalized
patient, which of the following is most appropriate?
1. 1/2 strength formula at 25 mL/hr, advance to goal rate and strength
over 5-7 days
2. 240 mL bolus feeds of full strength hypertonic formulas every 4
hours
3. full strength formula at 10-40 mL/hour and advance by 10-20
mL/hour every 8-12 hours to goal rate
4. 1/4 strength formula at goal rate. Advance to full strength over 3-5
days Answer: 3 Full strength formula at 10-40 mL/hour and advance
by 10-20 mL/hour every 8-12 hours to goal rate
◍ What is the current recommendation for initiating enteral feedings
in adults and children? Answer: Currently, it is recommended that
feedings in adults and children be initiated with full strength formulas
at a slow rate and steadily advanced.
,◍ 2 benefits of initiating enteral feedings at full strength formula at a
slow rate and steadily advancing? Answer: 1. Goal rates achieved
earlier
2. Reduces the risk for microbial contamination by minimizing the
number of times the formula is manipulated
◍ While a patient is receiving speech therapy, oral foods are provided
during the daytime hours. To meet the patient's nutritional
requirements, polymeric tube feeding is required during the night at a
rate of 75 mL per hour over 10 hours. The night feeding is an example
of:
1 bolus feeding
2. intermittent feeding
3. cyclic feeding
4. continuous feeding Answer: 3. cyclic feeding
◍ What is the general length for cyclic feedings? Answer: 8-20 hours
per day
◍ 3 Purposes of cyclic feedings? Answer: 1. Allows freedom from the
feeding equipment for a few hours each day
2. Ensures that nutrient requirements are met
3. Time off tube feeding during the day often increases appetite during
transition
, ◍ When are cyclic feedings typically given? Answer: overnight
◍ Which of the following individuals would best benefit from cyclic
tube feedings?
1. Status post CVA who has initiated oral foods during the day
2. Critically ill motorcycle accident victim in the ICU
3. Critically ill patients with diabetes and hyperglycemia
4. Postoperative bowel surgery patient who has an ileus Answer: 1.
Status post CVA who has initiated oral foods during the day
◍ Purpose of nocturnal feeds? Answer: frequently used to supplement
oral intake and promote unobstructed activity during the day
◍ Which type of insulin should be used when initiating enteral
nutrition in a hospitalized diabetic patient?
1. Premixed NPH/Regular insulin
2. Regular Insulin
3. NPH insulin
4. Insulin glargine Answer: 2. Regular insulin
◍ Why is short-acting insulin (regular insulin) typically used when
initating enteral nutrition? Answer: tolerance and titration may be
unpredictable, this type of insulin may minimize the risk of
hypoglycemia resulting from continued absorption fo insulin from an
WITH CORRECT ANSWERS GRADED A+
◍ Why would concentrated enteral solutions not be recommended for
nausea/vomiting? Answer: Concentrated enteral solutions generally
contain more fat and can contribute to enteral intolerance by
presenting a higher osmotic load to the GI tract. They also slow
gastric emptying.
◍ The initiation of enteral tube feeding should be delayed when the
patient is
1. hemodynamically unstable
2. at a decreased level of consciousness
3. without bowel sounds
4. scheduled for discharge Answer: 1. hemodynamically unstable
◍ EN should be delayed until these 3 things can be accomplished in
order to reduce the risk of intestinal ischemia? Answer: 1. patient is
fully volume resuscitated
2. hemodynamically stable
3. mesenteric perfusion has been restored
◍ Is evidence of bowel function (bowel sounds) required prior to
starting enteral nutrition? Answer: No
,◍ What is the evidence for not withholding EN until patient is fully
volume resuscitated, hemodynamically stable and mesenteric
perfusion has been restored? Answer: A recent retrospective trial
indicates early EN in hemodynamically unstable patients receiving
mechanical ventilation may decrease mortality; however, due to
inherent study limitations further prospective randomized trials are
needed before guideline changes can be made
◍ When initiating and advancing enteral feedings in the hospitalized
patient, which of the following is most appropriate?
1. 1/2 strength formula at 25 mL/hr, advance to goal rate and strength
over 5-7 days
2. 240 mL bolus feeds of full strength hypertonic formulas every 4
hours
3. full strength formula at 10-40 mL/hour and advance by 10-20
mL/hour every 8-12 hours to goal rate
4. 1/4 strength formula at goal rate. Advance to full strength over 3-5
days Answer: 3 Full strength formula at 10-40 mL/hour and advance
by 10-20 mL/hour every 8-12 hours to goal rate
◍ What is the current recommendation for initiating enteral feedings
in adults and children? Answer: Currently, it is recommended that
feedings in adults and children be initiated with full strength formulas
at a slow rate and steadily advanced.
,◍ 2 benefits of initiating enteral feedings at full strength formula at a
slow rate and steadily advancing? Answer: 1. Goal rates achieved
earlier
2. Reduces the risk for microbial contamination by minimizing the
number of times the formula is manipulated
◍ While a patient is receiving speech therapy, oral foods are provided
during the daytime hours. To meet the patient's nutritional
requirements, polymeric tube feeding is required during the night at a
rate of 75 mL per hour over 10 hours. The night feeding is an example
of:
1 bolus feeding
2. intermittent feeding
3. cyclic feeding
4. continuous feeding Answer: 3. cyclic feeding
◍ What is the general length for cyclic feedings? Answer: 8-20 hours
per day
◍ 3 Purposes of cyclic feedings? Answer: 1. Allows freedom from the
feeding equipment for a few hours each day
2. Ensures that nutrient requirements are met
3. Time off tube feeding during the day often increases appetite during
transition
, ◍ When are cyclic feedings typically given? Answer: overnight
◍ Which of the following individuals would best benefit from cyclic
tube feedings?
1. Status post CVA who has initiated oral foods during the day
2. Critically ill motorcycle accident victim in the ICU
3. Critically ill patients with diabetes and hyperglycemia
4. Postoperative bowel surgery patient who has an ileus Answer: 1.
Status post CVA who has initiated oral foods during the day
◍ Purpose of nocturnal feeds? Answer: frequently used to supplement
oral intake and promote unobstructed activity during the day
◍ Which type of insulin should be used when initiating enteral
nutrition in a hospitalized diabetic patient?
1. Premixed NPH/Regular insulin
2. Regular Insulin
3. NPH insulin
4. Insulin glargine Answer: 2. Regular insulin
◍ Why is short-acting insulin (regular insulin) typically used when
initating enteral nutrition? Answer: tolerance and titration may be
unpredictable, this type of insulin may minimize the risk of
hypoglycemia resulting from continued absorption fo insulin from an
