COMPREHENSIVE STUDY GUIDE FOR
INTRODUCTION TO CRITICAL CARE
NURSING- EDITION 7
- ANS>>Chapter06:NutritionalTherapy
b. Fluidandelectrolyteimbalancesandsepsis -
ANS>>1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Because
enteraltubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethe
majorcomplicationsforthistherapy
d. Topreventaspirationofthefeedings -
ANS>>.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastric
small-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement
?
d. Subclavianvein -
ANS>>3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcat
heterinsertion?
c. Obtainachestradiograph. -
ANS>>4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallows
tudy,thepatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortube
feeding,whatisthenextcriticalstep?
c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves -
ANS>>5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinu
ousflowtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause:
Elevatetheheadofthebed30degrees. -
ANS>>6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewoul
dcarryoutwhichinterventiontominimizeaspirationrisk?
d. tube feeding intolerance. -
ANS>>7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilky
greenfluid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas:
d. recheck the residual in 2hours -
ANS>>8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.
Thenurseholdsthetubefeeding,whichhadbeeninfusingat100mL/
hr.Thenurseknowsthatthenextactionshouldbe:
,a. Abdominal distention -
ANS>>9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolera
nce?
a. Clostridium difficile -
ANS>>10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrh
ea.Astoolspecimeniscollectedtocheckforwhichpossiblecause?
b. Infuseantibioticsthroughtheintravenousline. -
ANS>>11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurseli
stedpossibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizin
gtheplanofcare?
c. Prealbumin -
ANS>>12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemost
sensitiveindicatorofproteinsynthesisandcatabolism?
d. Phenytoin - ANS>>13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions?
d. Without nutritional stimulation, mucosal villi atrophy. -
ANS>>14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract?
c. potential for drug-nutrient interaction related to polypharmacy. - ANS>>15.An
important nutritional consideration in the elderly population is:
d. weight loss, elevated glucose, and dehydration -
ANS>>16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude:
a. 24hours - ANS>>17.In trauma patients ,enteral nutrition via nasogastric tube feedings
into the small bowel is best initiated within what time frame following the injury?
b. Fiber-addedformula -
ANS>>18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalc
areunitonaventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitamind
eficiencyandisunderweight.Whichformulafornutritionalassessmentismostappropriate?
d. Gut mucosa is preserved. -
ANS>>19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceof
nutritionaltherapy
b. The patient with ileitis -
ANS>>20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein?
, b. flushthetubeevery4hourswith20to30mLoftapwater. -
ANS>>21.Thebestnursingapproachtopreventfeedingtubeobstructionis:
c. 35kcal/kg/day -
ANS>>22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequire
mentsto:
b. impairing immune function - ANS>>23.Malnutritioncontributestoinfectionriskby
d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. -
ANS>>24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse:
a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.
d.
Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,
andfats. - ANS>>1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?
(Selectallthatapply.)
b. Changethetubingevery24hours.
d. Monitortriglyceridelevels. -
ANS>>2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?
(Selectallthatapply).
a. are most useful in heart failure and liver disease. - ANS>>3.Calorie-densefeedings:
(Selectallthatapply.)
b. elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload. - ANS>>4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.)
a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. -
ANS>>5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?
(Selectallthatapply.)
A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency.
D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E -
ANS>>Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__
d. Uncompensated
respiratory
acidosis;
INTRODUCTION TO CRITICAL CARE
NURSING- EDITION 7
- ANS>>Chapter06:NutritionalTherapy
b. Fluidandelectrolyteimbalancesandsepsis -
ANS>>1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Because
enteraltubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethe
majorcomplicationsforthistherapy
d. Topreventaspirationofthefeedings -
ANS>>.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastric
small-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement
?
d. Subclavianvein -
ANS>>3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcat
heterinsertion?
c. Obtainachestradiograph. -
ANS>>4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallows
tudy,thepatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortube
feeding,whatisthenextcriticalstep?
c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves -
ANS>>5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinu
ousflowtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause:
Elevatetheheadofthebed30degrees. -
ANS>>6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewoul
dcarryoutwhichinterventiontominimizeaspirationrisk?
d. tube feeding intolerance. -
ANS>>7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilky
greenfluid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas:
d. recheck the residual in 2hours -
ANS>>8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.
Thenurseholdsthetubefeeding,whichhadbeeninfusingat100mL/
hr.Thenurseknowsthatthenextactionshouldbe:
,a. Abdominal distention -
ANS>>9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolera
nce?
a. Clostridium difficile -
ANS>>10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrh
ea.Astoolspecimeniscollectedtocheckforwhichpossiblecause?
b. Infuseantibioticsthroughtheintravenousline. -
ANS>>11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurseli
stedpossibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizin
gtheplanofcare?
c. Prealbumin -
ANS>>12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemost
sensitiveindicatorofproteinsynthesisandcatabolism?
d. Phenytoin - ANS>>13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions?
d. Without nutritional stimulation, mucosal villi atrophy. -
ANS>>14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract?
c. potential for drug-nutrient interaction related to polypharmacy. - ANS>>15.An
important nutritional consideration in the elderly population is:
d. weight loss, elevated glucose, and dehydration -
ANS>>16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude:
a. 24hours - ANS>>17.In trauma patients ,enteral nutrition via nasogastric tube feedings
into the small bowel is best initiated within what time frame following the injury?
b. Fiber-addedformula -
ANS>>18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalc
areunitonaventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitamind
eficiencyandisunderweight.Whichformulafornutritionalassessmentismostappropriate?
d. Gut mucosa is preserved. -
ANS>>19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceof
nutritionaltherapy
b. The patient with ileitis -
ANS>>20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein?
, b. flushthetubeevery4hourswith20to30mLoftapwater. -
ANS>>21.Thebestnursingapproachtopreventfeedingtubeobstructionis:
c. 35kcal/kg/day -
ANS>>22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequire
mentsto:
b. impairing immune function - ANS>>23.Malnutritioncontributestoinfectionriskby
d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. -
ANS>>24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse:
a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.
d.
Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,
andfats. - ANS>>1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?
(Selectallthatapply.)
b. Changethetubingevery24hours.
d. Monitortriglyceridelevels. -
ANS>>2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?
(Selectallthatapply).
a. are most useful in heart failure and liver disease. - ANS>>3.Calorie-densefeedings:
(Selectallthatapply.)
b. elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload. - ANS>>4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.)
a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. -
ANS>>5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?
(Selectallthatapply.)
A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency.
D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E -
ANS>>Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__
d. Uncompensated
respiratory
acidosis;
