NSG 502 EXAM 3 2025/2026 QUESTIONS
AND ANSWERS 100% PASS
Which finding for a young adult who follows a vegan diet may indicate the need for cobalamin
supplementation?
a. Paresthesias
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling - ANS A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the patient will be
most at risk for signs of cobalamin deficiency, such as paresthesias, peripheral neuropathy, and
anemia. The other symptoms listed are associated with other nutritional deficiencies but would
not be associated with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum albumin level is
being admitted. Which assessment finding will the nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies - ANS C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease. The blood
pressure and level of consciousness are not directly affected by malnutrition. Food allergies are
not an indicator of nutritional status.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low
serum transferrin and albumin levels. What should the nurse encourage the patient to increase
in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate - ANS B
The patient's C-reactive protein and transferrin levels indicate low protein stores. The BMI is in
the obese range, so increasing caloric intake is not indicated. The data do not indicate a need for
increased carbohydrate or iron intake.
A patient who has just been started on enteral nutrition of full-strength formula at 100 mL/hr
has 6 liquid stools the first day. Which action should the nurse plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube. - ANS A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the feeding rate
or decrease the concentration of the feeding. Water should be given when patients receive
enteral feedings to prevent dehydration. When a closed enteral feeding system is used, the
tubing and formula are changed every 24 hrs. High residual volumes dont contribute to diarrhea
A young adult with extensive facial injuries from a motor vehicle crash is receiving continuous
enteral nutrition through a percutaneous endoscopic gastrostomy (PEG). Which action will the
nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANS B
The tube is flushed every 4 hours during continuous feedings to avoid tube obstruction. The
patient should be positioned with the head of the bed elevated. Crushed medications mixed in
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,with the formula are likely to clog the tube. An x-ray is obtained immediately after placement of
the PEG tube to check position, but daily x-rays are not needed.
A malnourished patient is receiving a parenteral nutrition (PN) infusion containing amino acids
and dextrose from a bag that was hung with a new tubing and filter 24 hours ago. The nurse
observes that about 50 mL remain in the PN container. Which action should the nurse take?
a. Add a new container of PN using the current tubing and filter.
b. Hang a new container of PN and change the IV tubing and filter.
c. Infuse the remaining 50 mL and then hang a new container of PN.
d. Ask the health care provider to clarify the written PN prescription. - ANS B
All PN solutions and tubings are changed at 24 hours. Infusion of the additional 50 mL will
increase patient risk for infection. The nurse (not the health care provider) is responsible for
knowing the indicated times for tubing and filter changes.
A patient's capillary blood glucose level is 120 mg/dL 6 hours after the nurse initiated a
parenteral nutrition (PN) infusion. What is the appropriate action by the nurse?
a. Obtain a venous blood glucose specimen.
b. Slow the infusion rate of the PN infusion.
c. Recheck the capillary blood glucose level in 4 to 6 hours.
d. Contact the health care provider for infusion rate changes. - ANS C
Mild hyperglycemia is expected during the first few days after PN is started and requires
ongoing monitoring. Because the glucose elevation is small and expected, infusion rate changes
are not needed. There is no need to obtain a venous specimen for comparison. Slowing the rate
of infusion is beyond nurses scope of practice and will decrease patients nutritional intake
After abdominal surgery, a patient with protein calorie malnutrition is receiving parenteral
nutrition (PN). Which is the best indicator that the patient is receiving adequate nutrition?
a. Serum albumin level is 3.5 mg/dL.
b. Fluid intake and output are balanced.
c. Surgical incision is healing normally.
d. Blood glucose is less than 110 mg/dL. - ANS C
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Because poor wound healing is a possible complication of malnutrition for this patient, normal
healing of the incision is an indicator of the effectiveness of the PN in providing adequate
nutrition. Blood glucose is monitored to prevent the complications of hyperglycemia and
hypoglycemia, but it does not indicate that the patient's nutrition is adequate. The intake and
output will be monitored, but do not indicate that the PN is effective. The albumin level is in the
low-normal range but does not reflect adequate caloric intake, which is also important for the
patient.
What action should the nurse take when caring for a patient with a soft, silicone nasogastric
tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
d. Administer medications mixed with enteral feeding formula. - ANS B
Elevate the head of the bed to decrease the risk of aspiration. The tubes are less likely to cause
mucosal damage than the stiffer polyvinyl chloride tubes used for nasogastric suction and do
not need to be replaced at certain intervals. Medications can be given through these tubes but
flushing after medication administration is important to avoid clogging. Do not mix medications
with formula, as the combination can clog the tube.
A patient is receiving continuous enteral nutrition through a small-bore silicone feeding tube.
What should the nurse plan for when this patient has a computed tomography (CT) scan
ordered?
a. Ask the health care provider to reschedule the scan.
b. Shut the feeding off 30 to 60 minutes before the scan.
c. Connect the feeding tube to continuous suction before and during the scan.
d. Send a suction catheter with the patient in case of aspiration during the scan. - ANS B
The feeding should be shut off 30 to 60 minutes before any procedure requiring the patient to
lie flat. Because the CT scan is ordered for diagnosis of patient problems, rescheduling is not
usually an option. Prevention, rather than treatment, of aspiration is needed. Small-bore
feeding tubes are soft and collapse easily with aspiration or suction, making nasogastric suction
of gastric contents unreliable.
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
AND ANSWERS 100% PASS
Which finding for a young adult who follows a vegan diet may indicate the need for cobalamin
supplementation?
a. Paresthesias
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling - ANS A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the patient will be
most at risk for signs of cobalamin deficiency, such as paresthesias, peripheral neuropathy, and
anemia. The other symptoms listed are associated with other nutritional deficiencies but would
not be associated with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum albumin level is
being admitted. Which assessment finding will the nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies - ANS C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease. The blood
pressure and level of consciousness are not directly affected by malnutrition. Food allergies are
not an indicator of nutritional status.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low
serum transferrin and albumin levels. What should the nurse encourage the patient to increase
in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate - ANS B
The patient's C-reactive protein and transferrin levels indicate low protein stores. The BMI is in
the obese range, so increasing caloric intake is not indicated. The data do not indicate a need for
increased carbohydrate or iron intake.
A patient who has just been started on enteral nutrition of full-strength formula at 100 mL/hr
has 6 liquid stools the first day. Which action should the nurse plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube. - ANS A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the feeding rate
or decrease the concentration of the feeding. Water should be given when patients receive
enteral feedings to prevent dehydration. When a closed enteral feeding system is used, the
tubing and formula are changed every 24 hrs. High residual volumes dont contribute to diarrhea
A young adult with extensive facial injuries from a motor vehicle crash is receiving continuous
enteral nutrition through a percutaneous endoscopic gastrostomy (PEG). Which action will the
nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANS B
The tube is flushed every 4 hours during continuous feedings to avoid tube obstruction. The
patient should be positioned with the head of the bed elevated. Crushed medications mixed in
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,with the formula are likely to clog the tube. An x-ray is obtained immediately after placement of
the PEG tube to check position, but daily x-rays are not needed.
A malnourished patient is receiving a parenteral nutrition (PN) infusion containing amino acids
and dextrose from a bag that was hung with a new tubing and filter 24 hours ago. The nurse
observes that about 50 mL remain in the PN container. Which action should the nurse take?
a. Add a new container of PN using the current tubing and filter.
b. Hang a new container of PN and change the IV tubing and filter.
c. Infuse the remaining 50 mL and then hang a new container of PN.
d. Ask the health care provider to clarify the written PN prescription. - ANS B
All PN solutions and tubings are changed at 24 hours. Infusion of the additional 50 mL will
increase patient risk for infection. The nurse (not the health care provider) is responsible for
knowing the indicated times for tubing and filter changes.
A patient's capillary blood glucose level is 120 mg/dL 6 hours after the nurse initiated a
parenteral nutrition (PN) infusion. What is the appropriate action by the nurse?
a. Obtain a venous blood glucose specimen.
b. Slow the infusion rate of the PN infusion.
c. Recheck the capillary blood glucose level in 4 to 6 hours.
d. Contact the health care provider for infusion rate changes. - ANS C
Mild hyperglycemia is expected during the first few days after PN is started and requires
ongoing monitoring. Because the glucose elevation is small and expected, infusion rate changes
are not needed. There is no need to obtain a venous specimen for comparison. Slowing the rate
of infusion is beyond nurses scope of practice and will decrease patients nutritional intake
After abdominal surgery, a patient with protein calorie malnutrition is receiving parenteral
nutrition (PN). Which is the best indicator that the patient is receiving adequate nutrition?
a. Serum albumin level is 3.5 mg/dL.
b. Fluid intake and output are balanced.
c. Surgical incision is healing normally.
d. Blood glucose is less than 110 mg/dL. - ANS C
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Because poor wound healing is a possible complication of malnutrition for this patient, normal
healing of the incision is an indicator of the effectiveness of the PN in providing adequate
nutrition. Blood glucose is monitored to prevent the complications of hyperglycemia and
hypoglycemia, but it does not indicate that the patient's nutrition is adequate. The intake and
output will be monitored, but do not indicate that the PN is effective. The albumin level is in the
low-normal range but does not reflect adequate caloric intake, which is also important for the
patient.
What action should the nurse take when caring for a patient with a soft, silicone nasogastric
tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
d. Administer medications mixed with enteral feeding formula. - ANS B
Elevate the head of the bed to decrease the risk of aspiration. The tubes are less likely to cause
mucosal damage than the stiffer polyvinyl chloride tubes used for nasogastric suction and do
not need to be replaced at certain intervals. Medications can be given through these tubes but
flushing after medication administration is important to avoid clogging. Do not mix medications
with formula, as the combination can clog the tube.
A patient is receiving continuous enteral nutrition through a small-bore silicone feeding tube.
What should the nurse plan for when this patient has a computed tomography (CT) scan
ordered?
a. Ask the health care provider to reschedule the scan.
b. Shut the feeding off 30 to 60 minutes before the scan.
c. Connect the feeding tube to continuous suction before and during the scan.
d. Send a suction catheter with the patient in case of aspiration during the scan. - ANS B
The feeding should be shut off 30 to 60 minutes before any procedure requiring the patient to
lie flat. Because the CT scan is ordered for diagnosis of patient problems, rescheduling is not
usually an option. Prevention, rather than treatment, of aspiration is needed. Small-bore
feeding tubes are soft and collapse easily with aspiration or suction, making nasogastric suction
of gastric contents unreliable.
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
