ASPEN Actual final Pretest Exam practice
Guide with complete and detailed solutions
2024/2025
Why might small bowel feeding increase the amount of feeding delivered in
postoperative patients with high GRVs? - correct answer Recovery of gastric emptying
may be slower than return of small bowel motility in post-operative patients
What is the preferred method of feeding in the small bowel? - correct answer
Continuous feeding (bolus and gravity feeding are poorly tolerated)
Why should holding of feedings be minimized? - correct answer To optimize meeting
calorie and protein needs
Would prone position be recommended in a patient with elevated GRVs? - correct
answer No, may increase the risk of aspiration
Which medications (2) may be beneficial in post-operative patients with high GRVs? -
correct answer Prokinetic agents (metoclopramide and erythromycin) to increase
motlitiy
Can Cisapride be used for increased motility? - correct answer No as the agent was
withdrawn from the US market in 2000 due to increasing reports of cardiac
dysrhythmias
Which of the following is a primary cause of oozing stools in a tube fed patient?
1. Fecal impaction
2. Fluid restriction
3. Physical inactivity
4. Narcotic usage - correct answer 1. Fecal impaction
,How does fecal impaction usually present? - correct answer Impaction can be
manifested by symptoms of diarrhea. Passage or secretion of fluid around the impaction
may be responsible for the loose stool. The patient may intermittently pass small
volumes of liquid stool and experience abdominal distention and cramping.
Name 3 things that commonly lead to constipation in enterally fed patients. - correct
answer 1. Fluid restriction
2. Physical inactivity
3. Narcotic usage
A home enteral nutrition patient recently treated for pneumonia is noted to have a new
onset diarrhea. Of the following, the first intervention should be to:
1. Change to an elemental feeding
2. Obtain an order for a bile-sequestering agent
3. Obtain a Clostridium difficile toxin stool assay
4. Obtain an order for an antidiarrheal medication - correct answer 3. Obtain a
Clostridium difficile toxin stool assay
List 4 possible causes of diarrhea in the tube fed patient. - correct answer 1.
Underlying medical condition
2. Tubefeeding intolerance
3. Medication effects
4. Infectious causes (bacterial contamination of enteral tube feeding formula or
equipment and C.difficile)
When should C.difficile be sent? - correct answer Should be ruled out in any patient
recently receiving antibiotic therapy, this should be done prior to ordering antidiarrheal
medication since antidiarrheal medications are not indicated in those with C.diff
Should antidiarrheal medications be used in C.difficile patients? - correct answer No
,Should elemental formula be used with C.difficile? - correct answer No, once a patient
is treated for C.difficile, the diarrhea quickly resolves. There is no need to change to an
elemental formula if there are no other indications for an elemental diet.
What is the optimal sodium concentration of an oral rehydration solution for patients
with short bowel syndrome?
1. 40 mmol/L
2. 90 mmol/L
3. 140 mmol/L
4. 190 mmol/L - correct answer 2. 90 mmol/L
What is the ideal sodium concentration for oral rehydration solutions dependent on? -
correct answer The segment of bowel function lost (jejunum, ileum, colon)
What is the range for sodium concentrations of homemade or commercial oral
rehydration solutions? - correct answer Ranges from 60-90 mmol/L
When implementing early enteral nutrition (EN) in critically ill patients, which of the
following factors is most likely to increase success in moving patients toward target
feeding rate?
1. degree of adherence to physician's orders
2. Combined use of EN and parenteral nutrition
3. Use of gastric feeding
4. Use of an interdisciplinary EN feeding protocol - correct answer 4. Use of an
interdisciplinary EN feeding protocol
What is the usually cause of challenges in early delivery of EN in the critically ill patient?
- correct answer Lack of standardized procedures
, List 4 advantages of centers that use enteral feeding protocols. - correct answer 1.
Provide more EN
2. Use less parenteral nutrition
3. Start EN sooner
4. Provide a greater percentage of the goal calories compared to centers that do not
have a EN feeding protocol in place
What is the maximum hang time for human breast milk (HBM)?
1. 4 hours
2. 8 hours
3. 12 hours
4. 24 hours - correct answer 1. 4 hours
What is the hang time for human breast milk (HBM) decanted into an open delivery
system for use in neonates and immunocompromised pediatric patients? - correct
answer Hang time no longer than 4 hours
How should human breast milk be prepared? - correct answer HBM should be
prepared for patient use in a clean environment using aseptic technique by specially
trained personnel. The recommendations also support the use of gloves during HBM
administration
What chemical should not be present in administration sets for HBM human breast
milk? - correct answer di (2-ethylhexyl) phthalate (DEHP) free
Which of the following is true regarding gastric residual volumes (GRV)?
1. GRV can be correlated with pneumonia and mortality
2. GRV correlates with the total volume of fluid present in the stomach
Guide with complete and detailed solutions
2024/2025
Why might small bowel feeding increase the amount of feeding delivered in
postoperative patients with high GRVs? - correct answer Recovery of gastric emptying
may be slower than return of small bowel motility in post-operative patients
What is the preferred method of feeding in the small bowel? - correct answer
Continuous feeding (bolus and gravity feeding are poorly tolerated)
Why should holding of feedings be minimized? - correct answer To optimize meeting
calorie and protein needs
Would prone position be recommended in a patient with elevated GRVs? - correct
answer No, may increase the risk of aspiration
Which medications (2) may be beneficial in post-operative patients with high GRVs? -
correct answer Prokinetic agents (metoclopramide and erythromycin) to increase
motlitiy
Can Cisapride be used for increased motility? - correct answer No as the agent was
withdrawn from the US market in 2000 due to increasing reports of cardiac
dysrhythmias
Which of the following is a primary cause of oozing stools in a tube fed patient?
1. Fecal impaction
2. Fluid restriction
3. Physical inactivity
4. Narcotic usage - correct answer 1. Fecal impaction
,How does fecal impaction usually present? - correct answer Impaction can be
manifested by symptoms of diarrhea. Passage or secretion of fluid around the impaction
may be responsible for the loose stool. The patient may intermittently pass small
volumes of liquid stool and experience abdominal distention and cramping.
Name 3 things that commonly lead to constipation in enterally fed patients. - correct
answer 1. Fluid restriction
2. Physical inactivity
3. Narcotic usage
A home enteral nutrition patient recently treated for pneumonia is noted to have a new
onset diarrhea. Of the following, the first intervention should be to:
1. Change to an elemental feeding
2. Obtain an order for a bile-sequestering agent
3. Obtain a Clostridium difficile toxin stool assay
4. Obtain an order for an antidiarrheal medication - correct answer 3. Obtain a
Clostridium difficile toxin stool assay
List 4 possible causes of diarrhea in the tube fed patient. - correct answer 1.
Underlying medical condition
2. Tubefeeding intolerance
3. Medication effects
4. Infectious causes (bacterial contamination of enteral tube feeding formula or
equipment and C.difficile)
When should C.difficile be sent? - correct answer Should be ruled out in any patient
recently receiving antibiotic therapy, this should be done prior to ordering antidiarrheal
medication since antidiarrheal medications are not indicated in those with C.diff
Should antidiarrheal medications be used in C.difficile patients? - correct answer No
,Should elemental formula be used with C.difficile? - correct answer No, once a patient
is treated for C.difficile, the diarrhea quickly resolves. There is no need to change to an
elemental formula if there are no other indications for an elemental diet.
What is the optimal sodium concentration of an oral rehydration solution for patients
with short bowel syndrome?
1. 40 mmol/L
2. 90 mmol/L
3. 140 mmol/L
4. 190 mmol/L - correct answer 2. 90 mmol/L
What is the ideal sodium concentration for oral rehydration solutions dependent on? -
correct answer The segment of bowel function lost (jejunum, ileum, colon)
What is the range for sodium concentrations of homemade or commercial oral
rehydration solutions? - correct answer Ranges from 60-90 mmol/L
When implementing early enteral nutrition (EN) in critically ill patients, which of the
following factors is most likely to increase success in moving patients toward target
feeding rate?
1. degree of adherence to physician's orders
2. Combined use of EN and parenteral nutrition
3. Use of gastric feeding
4. Use of an interdisciplinary EN feeding protocol - correct answer 4. Use of an
interdisciplinary EN feeding protocol
What is the usually cause of challenges in early delivery of EN in the critically ill patient?
- correct answer Lack of standardized procedures
, List 4 advantages of centers that use enteral feeding protocols. - correct answer 1.
Provide more EN
2. Use less parenteral nutrition
3. Start EN sooner
4. Provide a greater percentage of the goal calories compared to centers that do not
have a EN feeding protocol in place
What is the maximum hang time for human breast milk (HBM)?
1. 4 hours
2. 8 hours
3. 12 hours
4. 24 hours - correct answer 1. 4 hours
What is the hang time for human breast milk (HBM) decanted into an open delivery
system for use in neonates and immunocompromised pediatric patients? - correct
answer Hang time no longer than 4 hours
How should human breast milk be prepared? - correct answer HBM should be
prepared for patient use in a clean environment using aseptic technique by specially
trained personnel. The recommendations also support the use of gloves during HBM
administration
What chemical should not be present in administration sets for HBM human breast
milk? - correct answer di (2-ethylhexyl) phthalate (DEHP) free
Which of the following is true regarding gastric residual volumes (GRV)?
1. GRV can be correlated with pneumonia and mortality
2. GRV correlates with the total volume of fluid present in the stomach
