CRITICAL CARE NURSING 7TH
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Chapter06:NutritionalTherapy - correct ans:
,1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteraltubefeedingsare
notpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorcomplicationsforthistherapy -
correct ans:b. Fluidandelectrolyteimbalancesandsepsis
.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement? - correct
ans:d. Topreventaspirationofthefeedings
3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterinsertion? -
correct ans:d. Subclavianvein
4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,thepatientisplac
edonenteralfeedings.Followingplacementofanasogastrictubefortubefeeding,whatisthenextcriticalstep? -
correct ans:c. Obtainachestradiograph.
5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflowtubefeeding.T
henurseknowsthatthisapproachwaschosenbecause: - correct ans:c.
theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves
6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryoutwhichinterve
ntiontominimizeaspirationrisk? - correct ans:Elevatetheheadofthebed30degrees.
7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfluid.Thisisaconc
ernbecausethismostlikelydemonstratesthatthepatienthas: - correct ans:d. tube feeding intolerance.
8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenurseholdsthetube
feeding,whichhadbeeninfusingat100mL/hr.Thenurseknowsthatthenextactionshouldbe: - correct ans:d.
recheck the residual in 2hours
9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - correct ans:a.
Abdominal distention
, 10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Astoolspecimenisco
llectedtocheckforwhichpossiblecause? - correct ans:a. Clostridium difficile
11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpossibleinterven
tionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingtheplanofcare? - correct ans:b.
Infuseantibioticsthroughtheintravenousline.
12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensitiveindicatorofp
roteinsynthesisandcatabolism? - correct ans:c. Prealbumin
13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions? - correct ans:d. Phenytoin
14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - correct ans:d. Without
nutritional stimulation, mucosal villi atrophy.
15.An important nutritional consideration in the elderly population is: - correct ans:c. potential for drug-
nutrient interaction related to polypharmacy.
16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - correct ans:d. weight loss,
elevated glucose, and dehydration
17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best
initiated within what time frame following the injury? - correct ans:a. 24hours
18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunitonaventilator.T
henutritionassessmentnotesthatthepatienthasaproteinandvitamindeficiencyandisunderweight.Whichfor
mulafornutritionalassessmentismostappropriate? - correct ans:b. Fiber-addedformula
19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutritionaltherapy -
correct ans:d. Gut mucosa is preserved.