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TEST BANK INTRODUCTION TO CRITICAL CARE

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TEST BANK INTRODUCTION TO CRITICAL CARE
- (correct Answer) - Chapter06:NutritionalTherapy

b. Fluidandelectrolyteimbalancesandsepsis - (correct Answer) -
1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteraltubefeedingsare
notpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorcomplicationsforthistherapy

d. Topreventaspirationofthefeedings - (correct Answer)
- .Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement?

d. Subclavianvein - (correct Answer) -
3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterinsertion?

c. Obtainachestradiograph. - (correct Answer) -
4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,thepatientisplace
donenteralfeedings.Followingplacementofanasogastrictubefortubefeeding,whatisthenextcriticalstep?

c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves - (correct Answer) -
5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflowtubefeeding.Th
enurseknowsthatthisapproachwaschosenbecause:

Elevatetheheadofthebed30degrees. - (correct Answer) -
6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryoutwhichinterven
tiontominimizeaspirationrisk?

d. tube feeding intolerance. - (correct Answer) -
7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfluid.Thisisaconce
rnbecausethismostlikelydemonstratesthatthepatienthas:

d. recheck the residual in 2hours - (correct Answer) -
8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenurseholdsthetubef
eeding,whichhadbeeninfusingat100mL/hr.Thenurseknowsthatthenextactionshouldbe:

a. Abdominal distention - (correct Answer) -
9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance?

a. Clostridium difficile - (correct Answer) -
10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Astoolspecimeniscol
lectedtocheckforwhichpossiblecause?

b. Infuseantibioticsthroughtheintravenousline. - (correct Answer) -
11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpossibleinterventi
onsforthispatient.Whichinterventionneedscorrectionbeforefinalizingtheplanofcare?

c. Prealbumin - (correct Answer) -
12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensitiveindicatorofp
roteinsynthesisandcatabolism?

,d. Phenytoin - (correct Answer) - 13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions?

d. Without nutritional stimulation, mucosal villi atrophy. - (correct Answer) -
14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract?

c. potential for drug-nutrient interaction related to polypharmacy. - (correct Answer) - 15.An important
nutritional consideration in the elderly population is:

d. weight loss, elevated glucose, and dehydration - (correct Answer) -
16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude:

a. 24hours - (correct Answer) - 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 - (correct Answer) -
18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunitonaventilator.Th
enutritionassessmentnotesthatthepatienthasaproteinandvitamindeficiencyandisunderweight.Whichform
ulafornutritionalassessmentismostappropriate?

d. Gut mucosa is preserved. - (correct Answer) -
19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutritionaltherapy

b. The patient with ileitis - (correct Answer) -
20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein?

b. flushthetubeevery4hourswith20to30mLoftapwater. - (correct Answer) -
21.Thebestnursingapproachtopreventfeedingtubeobstructionis:

c. 35kcal/kg/day - (correct Answer) -
22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto:

b. impairing immune function - (correct Answer) - 23.Malnutritioncontributestoinfectionriskby

d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. - (correct Answer) -
24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse:

a. Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.

d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,andfats. -
(correct Answer) - 1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.)

b. Changethetubingevery24hours.

d. Monitortriglyceridelevels. - (correct Answer) -
2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?(Selectallthatapply).

a. are most useful in heart failure and liver disease. - (correct Answer) - 3.Calorie-densefeedings:

, (Selectallthatapply.)

b. elevatedbloodsugar.

c. infectionatthecathetersite.

d. volumeoverload. - (correct Answer) - 4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.)

a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.

b. Insulinmaybeaddedtoaparenteralnutritionsolution.

c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. - (correct Answer) -
5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?(Selectallthatapply.)

A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph.
E.Assessresiduals. ANS: B,D,C,A,E - (correct Answer) -
Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__

d. Uncompensated

respiratory

acidosis;

hyperoxygenated - (correct Answer) -
1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivecareunitatnoon.H
eisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevels:

pH7.31

PaCO248mmHg

Bicarbonate22mEq/L

PaO2115mmHg

O2saturation99%

d. Respiratoryalkalosis - (correct Answer) -
2.Thephysicianordersthefollowingmechanicalventilationsettingsforapatientwhoweighs75kg.Thepatientss
pontaneousrespiratoryrateis22breaths/
min.Whatarterialbloodgasabnormalitymayoccurifthepatientcontinuestobetachypneicattheseventilatorse
ttings?

Settings:

Tidalvolume:600mL(8mLperkg)

FiO2:0.5

Respiratoryrate:14breaths/min

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