CHAPTER 26 NUTRITION

1.

Whichfoodprovidestheonlyanimalsourceofcarbohydrate?

1)Beef
2)Eggs
3)Milk
4)Chicken
Rationale:Theonlyanimalsourceofcarbohydrateislactose,thesugarcontainedinmilk.Beef,eggs,
andchickendonotprovideasourceofcarbohydrate.
Duringanadmissionassessment,thepatientreportsthathetakesvitaminEsupplements
twiceaday.ThenurseshouldexplainthattakingvitaminEsupplementstwiceaday

2.

1)ensureshealthyvision.
2)canleadtotoxicity.
3)strengthenstheimmunesystem.
4)helpsmaintainbodytissues.
Rationale:Vitaminsarecriticalinbuildingandmaintainingbodytissues,supportingtheimmunesystem
tofightinfection,andensuringhealthyvision.Howeverwhenfatsolublevitamins,suchasvitaminsA,D,
E,andK,aresupplementedinlargedoses,toxicitymayoccur.

3.

Thenurseispreparinganenteralfeedingforapatientwhowillbereceivingintermittent

feedingsvianasogastrictubeforthefirsttime.Thepatientisconscious.Whichofthefollowingis
thepriorityinterventionbeforeadministeringthisfeeding?
1)Observewhetherthepatientcanspeak.
2)Injectairintothefeedingtubewhileauscultatingthestomach.
3)Aspiratestomachcontentsandmeasureresidualvolume.
4)Obtainanxrayofthechestandabdomen.
Rationale:ItisessentialtoverifythattheNGtubeisinthestomachandnottheairway.Theonlyreliable
methodamongthesefouristoobtainanxrayofthechestandabdomen.Forsubsequentfeedings,
however,itisnotpracticaltoobtainanxrayeachtime,andpresenceofformulainthestomach
complicatesthepHreadings.Therefore,thenurseshoulduseacombinationofbedsidetechniques,
includingobservingappearanceandmeasuringtheamountofgastricresidualvolume,askingthepatient
tospeak,andinjectingair("whoosh"test)whileauscultatingthestomach.
Theheadofthebedofapatientwhoisreceivingenteralfeedingsiselevatedto45
degrees.Whichcomplicationassociatedwithenteralfeedingsdoesthisinterventionhelp

4.

prevent?
1)Aspiration
2).Diarrhea
3)Infection
4)Electrolyteimbalance

Rationale:Theheadofthebed(HOB)shouldbeelevatedtoatleast30to45degreesduringenteral
feedingadministrationtopreventaspiration.MaintaininganelevatedHOBaidsindigestionbyhelpingthe
transitoffeedingthroughtheGItract.Diarrhea,infection,andelectrolyteimbalanceareallcomplications
associatedwithenteralfeeding,buttheycannotbepreventedbyelevatingtheheadofthebed.
Duringparenteralnutritionadministration,anursebreakssteriletechnique.Forwhich
complicationdoesthisplacethepatientatrisk?

5.

1)Airembolism
2)Sepsis
3)Thrombosis
4)Pneumothorax
Rationale:Abreakinsteriletechniqueplacesthepatientatriskforsepsis.Airembolismcanoccurwhen
theintravenoustubingisdisconnectedfromthecatheterhub.Thrombosisoccursasaresultofirritationof
theveinfromthecentralvenouscatheter.Pneumothoraxisacomplicationofcentralvenouscatheter
insertion.

6.

Anadultpatientwhoisreceivingacontinuousenteralfeedingat80ml/hrhasaresidual

volumeof120ml6hoursafterthelastcheck.Howshouldthenurseproceed?
1)Continueadministeringtheenteralfeeding
2)Holdtheenteralfeedingandnotifythephysicianimmediately
3)Holdthefeedingfor1hour,andrecheck
4)Holdthefeedingfor2hours,thenresumethefeeding
Rationale:Thenurseshouldcheckenteralfeedingresidualevery4to6hours.Ifresidualis10%greater
thantheformulaflowratefor1hour(oralternatively,atotalof150ml),thenurseshouldholdthefeeding
for1hourandrecheck.Ifresidualisstillnotwithinnormallimits,sheshouldnotifythephysician.
Whichactionshouldthenursetakeafteradministeringadoseofmedicationthrougha
percutaneousendoscopicgastrostomy(PEG)tube?

7.

1)Continuetheenteralfeeding.
2)Flushthetubewith30mlofwater.
3)Wait2hoursbeforeresumingthefeeding.
4)Checkresidualvolume.
Rationale:
ThenurseshouldflushthePEGtubewith30mlofwaterbeforeandafteradministeringamedication
throughthetube.Thetubefeedingshouldbeheldfor1hourbeforeand1hourafteradministeringsome
medications,suchasphenytoin(Dilantin).Itisnotnecessarytoholdthefeedingfor2hours.Residual
volumeshouldnotbecheckedimmediatelyafteradministeringmedications.