ASPEN Self-Study CNSC Exam 2026–2027
| Accurate Real Exam Questions and
Verified Correct Answers
What type of tablets should be crushed for administration via an enteral feeding
tube? - ANSWER -Only immediate release tablets should be crushed fro
administration via an enteral feeding tube.
Why are enteric coated and film coated tablets not crushed for administration via
an EN feeding tube? - ANSWER -Enteric coated or film coated tablets do not
crush well and tend to clump and increase the risk of clogging the tube.
Why are modified release dosage forms of drugs inappropriate to crush and give
via EN feeding tubes? - ANSWER -Modified release dosage forms (often
designated with abbreviations such as XL, XR, SR, CD etc.) are inappropriate to
crush and give via EN feeding tube because crushing these dosage forms destroys
their modified releasing properties. This may lead to an excessive dose of the drug
being released at one time (instead of slowly over a longer period of time), which
can lead to adverse effects and has even been reported as a cause of death
Which of the following describes an optimal method of preparing and
administering medications via an enteral feeding tube?
1. Crush tablets and add them directly in the EN formula
2. Administer liquid formulations undiluted to minimize fluid overload
3. Flush the tube with water before and after each medication administered
4. Add crushed tablets to liquid medication sand administer the mixture all together
- ANSWER -3. Flush the tube with water before and after each medication
administered
Why should the EN tube be flushed before and after each medication? -
ANSWER -Helps to avoid physical interactions both between medications and
between medications and formula.
How should liquid formulations be administered? Why? - ANSWER -Many
liquid medications are hyperosmolar which can lead to diarrhea and/or have high
,viscosity which can lead to tube clogging, so liquid dosage forms should be diluted
with water prior to administration
In patients with severe acute pancreatitis enteral nutrition has been documented to
provide the following benefits over parenteral nutrition EXCEPT:
1. decreased infection rate
2. decreased hospital LOS
3. decreased pain
4. decreased mortality - ANSWER -3. Decreased pain
List 5 benefits in patients with severe acute pancreatitis on EN vs. PN nutrition
support - ANSWER -1. significant reduction in infectious morbidity
2. decreased hospital LOS
3. Reduced need for surgical intervention
4. Reduced multiple organ failure
5. Decreased mortality
In patient with fat malabsorption, an enteral product containing which of the
following can provide a concentrated source of energy?
1. MCT
2. Free amino acids
3. Fructooligosaccharides
4. Long chain triglycerides - ANSWER -1. MCTs
What nutrient can be used to provide a concentrated source of energy to patients
with fat malabsorption or damage to lymphatic vessels? Why? - ANSWER -MCT
MCT are absorbed directly into the bloodstream and enter portal circulation
bypassing the need for pancreatic enzymes, bile, bile transport in the lymphatic
system and carnitine dependent transport into the mitochondria.
Which of the following is true regarding infectious complications associated with
enteral feedings?
1. Bacterial contamination may originate from the patient's throat, lung and
stomach
2. Exceeding manufacture hang-time guidelines is not a risk for bacterial
contamination
,3. Open systems have less exogenous bacterial contamination
4. The enteral tube site should be routinely cultured - ANSWER -1. Bacterial
contamination may originate from the patient's throat, lung and stomach
Name the 2 routes of bacterial contamination of enteral feeds. - ANSWER -1.
Exogenously through the feeding equipment
2. Endogenously through retrograde contamination of the feeding apparatus from
the patient's own infected secretions
What is bacterial contamination correlated with? - ANSWER -there is a
correlation between prolonged length of enteral product hang time and bacterial
contamination
Which type of system provides the most opportunity for contamination? Why? -
ANSWER -Open-system due to nursing manipulation when adding more formula
to the bag
Is there an indication for routine cultures in the uncomplicated enterally fed
patient? - ANSWER -No
Mrs. Jones suffered from a stroke 2 weeks ago and has significant dysphagia. A
PEG was placed and an isotonic enteral formula has been infusing continuously at
goal rate for 2 days with appropriate flushing (30 mL 3x/day). Mrs. Jones begins to
complain of bloating and is mildly distended (to 4 cm from baseline) upon
examination. Which of the following interventions would be the best initial
strategy to reduce her unpleasant symptoms?
1. Initiate a bowel regimen if constipation suspected
2. Hold enteral nutrition and initiate a pain reliever
3. Switch to a higher fiber enteral nutrition formula
4. Change to bolus feeding regimen - ANSWER -1. Initiate a bowel regimen if
constipation suspected
List 10 possible reason for abdominal distention upon enteral tube feeding. -
ANSWER -1. Rapid administration of feeding (i.e. bolus feeds)
2. Use of hyperosmolar solution (concentrated formulas)
3. Medications that slow peristalsis (pain relievers, anticholinergics)
4. Excess air in the stomach or intestines
5. Tube migration from stomach to small intestine
6. Infection
, 7. Cold formula
8. Inadequate fluid provision leading to constipation
9. Bacterial contamination
10. Fat, fiber or lactose intolerance
What should be considered in the enterally fed patient with abdominal distention?
- ANSWER -Aggressive bowel regimens need to be considered in these patients to
reduce distention and prevent impaction
Is holding enteral feedings indicated with abdominal distention? - ANSWER -
Holding enteral feedings is generally not indicated unless abdominal girth exceeds
the baseline measurement by at least 8-10 cm
What GI effects do agents such as narcotics or diphenhydramine have? -
ANSWER -Documented anticholinergic effects often resulting in constipation
Should fiber be used in abdominal distention? - ANSWER -Fiber may help to
promote regular bowel movements in patients receiving enteral nutrition, but may
also lead to excess gas production and increased abdominal distention. Providing
additional free water flushes may help to decrease distention
A terminally ill patient at home on hospice complains of nausea during enteral
feedings. A decision is made to discontinue enteral feeding. Which of the
following is true regarding the tying patient?
1. Intravenous hydration should be used to reduce symptoms of nausea, vomiting,
diarrhea and respiratory distress
2. Dehydration, starvation and ketosis produces a euphoric state that enhances the
perception of hunger
3. The most common symptom when nutrition and hydration are withheld is dry
mouth
4. Electrolyte imbalance should be expected and may produce a degree of
analgesia - ANSWER -3. The most common symptom when nutrition and
hydration are withheld is dry mouth
In the terminally ill hospice patient what is the recommendation for EN? Why? -
ANSWER -Enteral feeding and hydration do not always ensure comfort. During
starvation the body begins to use fat as the predominant energy source leading to
increased ketone production with a resulting euphoria. Feeding even small amounts
can prevent ketonemia and prolong the sense of hunger.
| Accurate Real Exam Questions and
Verified Correct Answers
What type of tablets should be crushed for administration via an enteral feeding
tube? - ANSWER -Only immediate release tablets should be crushed fro
administration via an enteral feeding tube.
Why are enteric coated and film coated tablets not crushed for administration via
an EN feeding tube? - ANSWER -Enteric coated or film coated tablets do not
crush well and tend to clump and increase the risk of clogging the tube.
Why are modified release dosage forms of drugs inappropriate to crush and give
via EN feeding tubes? - ANSWER -Modified release dosage forms (often
designated with abbreviations such as XL, XR, SR, CD etc.) are inappropriate to
crush and give via EN feeding tube because crushing these dosage forms destroys
their modified releasing properties. This may lead to an excessive dose of the drug
being released at one time (instead of slowly over a longer period of time), which
can lead to adverse effects and has even been reported as a cause of death
Which of the following describes an optimal method of preparing and
administering medications via an enteral feeding tube?
1. Crush tablets and add them directly in the EN formula
2. Administer liquid formulations undiluted to minimize fluid overload
3. Flush the tube with water before and after each medication administered
4. Add crushed tablets to liquid medication sand administer the mixture all together
- ANSWER -3. Flush the tube with water before and after each medication
administered
Why should the EN tube be flushed before and after each medication? -
ANSWER -Helps to avoid physical interactions both between medications and
between medications and formula.
How should liquid formulations be administered? Why? - ANSWER -Many
liquid medications are hyperosmolar which can lead to diarrhea and/or have high
,viscosity which can lead to tube clogging, so liquid dosage forms should be diluted
with water prior to administration
In patients with severe acute pancreatitis enteral nutrition has been documented to
provide the following benefits over parenteral nutrition EXCEPT:
1. decreased infection rate
2. decreased hospital LOS
3. decreased pain
4. decreased mortality - ANSWER -3. Decreased pain
List 5 benefits in patients with severe acute pancreatitis on EN vs. PN nutrition
support - ANSWER -1. significant reduction in infectious morbidity
2. decreased hospital LOS
3. Reduced need for surgical intervention
4. Reduced multiple organ failure
5. Decreased mortality
In patient with fat malabsorption, an enteral product containing which of the
following can provide a concentrated source of energy?
1. MCT
2. Free amino acids
3. Fructooligosaccharides
4. Long chain triglycerides - ANSWER -1. MCTs
What nutrient can be used to provide a concentrated source of energy to patients
with fat malabsorption or damage to lymphatic vessels? Why? - ANSWER -MCT
MCT are absorbed directly into the bloodstream and enter portal circulation
bypassing the need for pancreatic enzymes, bile, bile transport in the lymphatic
system and carnitine dependent transport into the mitochondria.
Which of the following is true regarding infectious complications associated with
enteral feedings?
1. Bacterial contamination may originate from the patient's throat, lung and
stomach
2. Exceeding manufacture hang-time guidelines is not a risk for bacterial
contamination
,3. Open systems have less exogenous bacterial contamination
4. The enteral tube site should be routinely cultured - ANSWER -1. Bacterial
contamination may originate from the patient's throat, lung and stomach
Name the 2 routes of bacterial contamination of enteral feeds. - ANSWER -1.
Exogenously through the feeding equipment
2. Endogenously through retrograde contamination of the feeding apparatus from
the patient's own infected secretions
What is bacterial contamination correlated with? - ANSWER -there is a
correlation between prolonged length of enteral product hang time and bacterial
contamination
Which type of system provides the most opportunity for contamination? Why? -
ANSWER -Open-system due to nursing manipulation when adding more formula
to the bag
Is there an indication for routine cultures in the uncomplicated enterally fed
patient? - ANSWER -No
Mrs. Jones suffered from a stroke 2 weeks ago and has significant dysphagia. A
PEG was placed and an isotonic enteral formula has been infusing continuously at
goal rate for 2 days with appropriate flushing (30 mL 3x/day). Mrs. Jones begins to
complain of bloating and is mildly distended (to 4 cm from baseline) upon
examination. Which of the following interventions would be the best initial
strategy to reduce her unpleasant symptoms?
1. Initiate a bowel regimen if constipation suspected
2. Hold enteral nutrition and initiate a pain reliever
3. Switch to a higher fiber enteral nutrition formula
4. Change to bolus feeding regimen - ANSWER -1. Initiate a bowel regimen if
constipation suspected
List 10 possible reason for abdominal distention upon enteral tube feeding. -
ANSWER -1. Rapid administration of feeding (i.e. bolus feeds)
2. Use of hyperosmolar solution (concentrated formulas)
3. Medications that slow peristalsis (pain relievers, anticholinergics)
4. Excess air in the stomach or intestines
5. Tube migration from stomach to small intestine
6. Infection
, 7. Cold formula
8. Inadequate fluid provision leading to constipation
9. Bacterial contamination
10. Fat, fiber or lactose intolerance
What should be considered in the enterally fed patient with abdominal distention?
- ANSWER -Aggressive bowel regimens need to be considered in these patients to
reduce distention and prevent impaction
Is holding enteral feedings indicated with abdominal distention? - ANSWER -
Holding enteral feedings is generally not indicated unless abdominal girth exceeds
the baseline measurement by at least 8-10 cm
What GI effects do agents such as narcotics or diphenhydramine have? -
ANSWER -Documented anticholinergic effects often resulting in constipation
Should fiber be used in abdominal distention? - ANSWER -Fiber may help to
promote regular bowel movements in patients receiving enteral nutrition, but may
also lead to excess gas production and increased abdominal distention. Providing
additional free water flushes may help to decrease distention
A terminally ill patient at home on hospice complains of nausea during enteral
feedings. A decision is made to discontinue enteral feeding. Which of the
following is true regarding the tying patient?
1. Intravenous hydration should be used to reduce symptoms of nausea, vomiting,
diarrhea and respiratory distress
2. Dehydration, starvation and ketosis produces a euphoric state that enhances the
perception of hunger
3. The most common symptom when nutrition and hydration are withheld is dry
mouth
4. Electrolyte imbalance should be expected and may produce a degree of
analgesia - ANSWER -3. The most common symptom when nutrition and
hydration are withheld is dry mouth
In the terminally ill hospice patient what is the recommendation for EN? Why? -
ANSWER -Enteral feeding and hydration do not always ensure comfort. During
starvation the body begins to use fat as the predominant energy source leading to
increased ketone production with a resulting euphoria. Feeding even small amounts
can prevent ketonemia and prolong the sense of hunger.
