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NUR 155 Nutrition – Enteral Nutrition &
Tube Feeding Management Practice
MCQs with Rationales
Exam Structure:
This document covers nursing management of enteral nutrition and tube feeding for
NUR 155 Nutrition, focusing on safe administration, monitoring, and complication
prevention. It includes multiple-choice questions with detailed rationales to support
exam preparation and reinforce clinical decision-making related to nutritional support.
Nursing / Enteral Nutrition, Tube Feeding Management
1. Why does the nurse elevate the head of the bed to 30 degrees for a
patient receiving an intermittent tube feeding?
A. Elevating the head of the bed reduces the risk for aspiration.
B. Proper elevation of the head of the bed promotes the patient's digestion.
C. Acid reflux is reduced when the head of the bed is elevated at least 30
degrees.
D. Nutrients are absorbed more efficiently when the head of the bed is
elevated.
Correct Answer: A. Elevating the head of the bed reduces the risk for
aspiration.
Rationale:
1. Aspiration of gastric or enteral feeding contents into the lungs is a
serious, potentially fatal complication.
2. Elevating the head of the bed to at least 30-45 degrees uses gravity to
keep stomach contents in the stomach and prevents reflux into the
esophagus.
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3. While elevation may secondarily reduce acid reflux (C), the primary
and most critical reason is aspiration prevention. Digestion (B) and
nutrient absorption (D) are not significantly affected by bed position.
2. What is the proper response to the nurse's observation that the
patient's closed-system enteral feeding has 150 mL of formula
remaining and that the infusion order rate is for 50 mL/hr?
A. Recalculate the present drip factor for accuracy.
B. Terminate the fluid, and prepare to hang a new bag of formula.
C. Plan to check the feeding for completion within the next 3 hours.
D. Check with the pharmacy to see if the formula has been hanging too long.
Correct Answer: C. Plan to check the feeding for completion within the
next 3 hours.
Rationale:
1. Calculation: Remaining volume (150 mL) ÷ Infusion rate (50 mL/hr)
= 3 hours until completion.
2. Closed-system enteral formulas are typically stable for 24-48 hours
once hung.
3. Terminating the feeding (B) is wasteful and interrupts prescribed
nutrition. Recalculating drip factor (A) is unnecessary with an
infusion pump. Checking with pharmacy (D) is not indicated as the
hang time is within safe limits if started within the current 24-hour
period.
3. After unsuccessfully attempting to flush a nasogastric (NG) tube
with water, what is the most appropriate action for the nurse to take?
A. Flush the tube with ginger ale.
B. Use apple juice to flush the tube.
C. Obtain a product designed to unclog NG tubes.
D. Force-flush the system with sterile normal saline.
Correct Answer: C. Obtain a product designed to unclog NG tubes.
Rationale:
1. Never force-flush a clogged tube (D); this can rupture the tube or
cause injury.
2. Carbonated beverages (A) and acidic juices (B) are not
recommended as they can cause formula coagulation, worsen clogs,
and alter tube integrity.
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3. Enzyme-based declogging solutions (e.g., containing pancreatic
enzymes) are specifically designed to safely break down formula clots
without damaging the tube or harming the patient.
4. How could the nurse assess the patency of a nasogastric (NG) tube
being used for enteral nutrition?
A. Elevate the head of the patient's bed to at least 30 degrees.
B. Use an intravenous fluid infusion set.
C. Check the gastric residual volume.
D. Monitor the amount of intake the patient tolerates in an 8-hour period.
Correct Answer: C. Check the gastric residual volume.
Rationale:
1. Patency means the tube is open and not clogged.
2. The ability to aspirate gastric contents (residual volume) confirms
the tube is open and likely still in the stomach. Inability to aspirate
may indicate occlusion or displacement.
3. Elevating the head of the bed (A) is for safety, not patency. IV sets (B)
are not for enteral feeding. Monitoring intake tolerance (D) assesses
gastrointestinal function, not tube patency.
5. Which nursing action is appropriate when feeding gastric residual
is 50 mL?
A. Return it to the stomach via the feeding tube.
B. Dispose of the residual contents down the commode.
C. Discard the stomach contents as a liquid biohazard.
D. Return half of the volume to the stomach, and discard the rest.
Correct Answer: A. Return it to the stomach via the feeding tube.
Rationale:
1. Standard Protocol: Gastric residual volumes (GRV) less than 250-
500 mL (institution-specific, but commonly 250 mL) are typically
returned to prevent electrolyte and fluid loss.
2. A residual of 50 mL is low and expected, indicating adequate gastric
emptying.
3. Returning the aspirate preserves gastric acid, electrolytes, and
digestive enzymes. Discarding it (B, C, D) is unnecessary and can
contribute to fluid and electrolyte imbalances.
NUR 155 Nutrition – Enteral Nutrition &
Tube Feeding Management Practice
MCQs with Rationales
Exam Structure:
This document covers nursing management of enteral nutrition and tube feeding for
NUR 155 Nutrition, focusing on safe administration, monitoring, and complication
prevention. It includes multiple-choice questions with detailed rationales to support
exam preparation and reinforce clinical decision-making related to nutritional support.
Nursing / Enteral Nutrition, Tube Feeding Management
1. Why does the nurse elevate the head of the bed to 30 degrees for a
patient receiving an intermittent tube feeding?
A. Elevating the head of the bed reduces the risk for aspiration.
B. Proper elevation of the head of the bed promotes the patient's digestion.
C. Acid reflux is reduced when the head of the bed is elevated at least 30
degrees.
D. Nutrients are absorbed more efficiently when the head of the bed is
elevated.
Correct Answer: A. Elevating the head of the bed reduces the risk for
aspiration.
Rationale:
1. Aspiration of gastric or enteral feeding contents into the lungs is a
serious, potentially fatal complication.
2. Elevating the head of the bed to at least 30-45 degrees uses gravity to
keep stomach contents in the stomach and prevents reflux into the
esophagus.
, 2|Page
3. While elevation may secondarily reduce acid reflux (C), the primary
and most critical reason is aspiration prevention. Digestion (B) and
nutrient absorption (D) are not significantly affected by bed position.
2. What is the proper response to the nurse's observation that the
patient's closed-system enteral feeding has 150 mL of formula
remaining and that the infusion order rate is for 50 mL/hr?
A. Recalculate the present drip factor for accuracy.
B. Terminate the fluid, and prepare to hang a new bag of formula.
C. Plan to check the feeding for completion within the next 3 hours.
D. Check with the pharmacy to see if the formula has been hanging too long.
Correct Answer: C. Plan to check the feeding for completion within the
next 3 hours.
Rationale:
1. Calculation: Remaining volume (150 mL) ÷ Infusion rate (50 mL/hr)
= 3 hours until completion.
2. Closed-system enteral formulas are typically stable for 24-48 hours
once hung.
3. Terminating the feeding (B) is wasteful and interrupts prescribed
nutrition. Recalculating drip factor (A) is unnecessary with an
infusion pump. Checking with pharmacy (D) is not indicated as the
hang time is within safe limits if started within the current 24-hour
period.
3. After unsuccessfully attempting to flush a nasogastric (NG) tube
with water, what is the most appropriate action for the nurse to take?
A. Flush the tube with ginger ale.
B. Use apple juice to flush the tube.
C. Obtain a product designed to unclog NG tubes.
D. Force-flush the system with sterile normal saline.
Correct Answer: C. Obtain a product designed to unclog NG tubes.
Rationale:
1. Never force-flush a clogged tube (D); this can rupture the tube or
cause injury.
2. Carbonated beverages (A) and acidic juices (B) are not
recommended as they can cause formula coagulation, worsen clogs,
and alter tube integrity.
, 3|Page
3. Enzyme-based declogging solutions (e.g., containing pancreatic
enzymes) are specifically designed to safely break down formula clots
without damaging the tube or harming the patient.
4. How could the nurse assess the patency of a nasogastric (NG) tube
being used for enteral nutrition?
A. Elevate the head of the patient's bed to at least 30 degrees.
B. Use an intravenous fluid infusion set.
C. Check the gastric residual volume.
D. Monitor the amount of intake the patient tolerates in an 8-hour period.
Correct Answer: C. Check the gastric residual volume.
Rationale:
1. Patency means the tube is open and not clogged.
2. The ability to aspirate gastric contents (residual volume) confirms
the tube is open and likely still in the stomach. Inability to aspirate
may indicate occlusion or displacement.
3. Elevating the head of the bed (A) is for safety, not patency. IV sets (B)
are not for enteral feeding. Monitoring intake tolerance (D) assesses
gastrointestinal function, not tube patency.
5. Which nursing action is appropriate when feeding gastric residual
is 50 mL?
A. Return it to the stomach via the feeding tube.
B. Dispose of the residual contents down the commode.
C. Discard the stomach contents as a liquid biohazard.
D. Return half of the volume to the stomach, and discard the rest.
Correct Answer: A. Return it to the stomach via the feeding tube.
Rationale:
1. Standard Protocol: Gastric residual volumes (GRV) less than 250-
500 mL (institution-specific, but commonly 250 mL) are typically
returned to prevent electrolyte and fluid loss.
2. A residual of 50 mL is low and expected, indicating adequate gastric
emptying.
3. Returning the aspirate preserves gastric acid, electrolytes, and
digestive enzymes. Discarding it (B, C, D) is unnecessary and can
contribute to fluid and electrolyte imbalances.
