RN ATI NUTRITION PROCTORED
EXAM 2025 | 150Q EXAM + VERIFIED
RATIONALES
Enteral Parenteral TPN Diet Therapy A+
Answers
,1. A home health nurse is caring for a client who has
dysphagia and a new PEG tube. Which of the following is an
appropriate action for the nurse to take? (NCLEX - Multiple
Choice)
a. Ensure the state health department has been notified
b. Administer feeding with 60 mL syringe bolus
c. Educate family on checking residual every 4 hours
d. Assess for skin necrosis at insertion site
Answer: c. Educate family on checking residual every 4 hours
Verified Rationale: Residual checks every 4 hours prevent aspiration. State notification not required for
PEG tubes. Bolus feeding requires larger syringes (>60 mL). Mild redness expected at site but necrosis
rare.
2. A nurse is caring for a client who has a vented NG tube set
to low intermittent suction and has vomited. Which of the
following actions should the nurse perform first? (NCLEX -
Multiple Choice)
a. Administer an antiemetic medication
b. Evaluate functioning of the suction device
c. Provide oral hygiene care
d. Replace the NG tube
Answer: b. Evaluate functioning of the suction device
Verified Rationale: Vomiting may indicate NG tube clogging or suction malfunction causing gastric
distention. First priority is equipment assessment. Antiemetic, oral care, or tube replacement follows after
confirming function.
3. Case Study Scenario (NGN - Select All That Apply):
A nurse is initiating enteral feedings for a client with the following orders:
● Feeding: 1/2 strength Isocal 240 mL/hr via PEG tube
● Vital signs: Temp 37.2°C, HR 88/min, BP 118/74, RR 16/min, SpO2 96%
Select all appropriate interventions:
☐ Advance feeding rate by 10 mL/hr q4h if tolerated
☐ Check residual before each feeding and every 4 hours
☐ Elevate HOB 30-45° during feeding
☐ Flush tubing with 30 mL water after each feeding
☐ Assess bowel sounds prior to initiation
Answer: ☐ Check residual before each feeding and every 4 hours | ☐ Elevate HOB 30-45°
, during feeding | ☐ Flush tubing with 30 mL water after feeding**
Verified Rationale: Residual prevents aspiration, HOB elevation reduces reflux risk, flushing
prevents clogging. Rate advancement requires tolerance first. Bowel sounds alone insufficient for
initiation.
4. While performing a routine assessment, a nurse notices
formula leaking around the client's PEG tube. Which of the
following actions should the nurse take first? (NCLEX -
Multiple Choice)
a. Initiate a requisition for tube replacement
b. Report leakage to the provider
c. Cleanse site and apply occlusive dressing
d. Assess stoma measurement
Answer: d. Assess stoma measurement
Verified Rationale: First assess if tube migrated (balloon deflation/leakage). Replacement requisition
premature without assessment. Cleaning follows measurement. Provider notification after initial
assessment.
5. A nurse is calculating tube feeding for a client weighing 70
kg. Order: 25 kcal/kg/day, 1.5 g protein/kg/day. Approximate
volume of 1 kcal/mL formula needed daily?
a. 1500 mL
b. 1750 mL
c. 2000 mL
d. 2250 mL
Answer: b. 1750 mL
Verified Rationale: 70 kg × 25 kcal/kg = 1750 kcal needed. 1750 kcal ÷ 1 kcal/mL = 1750 mL formula
daily.
6. Client has NG tube order: Jevity 1.5 (1.5 kcal/mL) at 60
mL/hr continuous. Daily kcal intake?
a. 1440 kcal
b. 1800 kcal
c. 2160 kcal
d. 2520 kcal
Answer: c. 2160 kcal
Verified Rationale: 60 mL/hr × 24 hr × 1.5 kcal/mL = 2160 kcal/day.
EXAM 2025 | 150Q EXAM + VERIFIED
RATIONALES
Enteral Parenteral TPN Diet Therapy A+
Answers
,1. A home health nurse is caring for a client who has
dysphagia and a new PEG tube. Which of the following is an
appropriate action for the nurse to take? (NCLEX - Multiple
Choice)
a. Ensure the state health department has been notified
b. Administer feeding with 60 mL syringe bolus
c. Educate family on checking residual every 4 hours
d. Assess for skin necrosis at insertion site
Answer: c. Educate family on checking residual every 4 hours
Verified Rationale: Residual checks every 4 hours prevent aspiration. State notification not required for
PEG tubes. Bolus feeding requires larger syringes (>60 mL). Mild redness expected at site but necrosis
rare.
2. A nurse is caring for a client who has a vented NG tube set
to low intermittent suction and has vomited. Which of the
following actions should the nurse perform first? (NCLEX -
Multiple Choice)
a. Administer an antiemetic medication
b. Evaluate functioning of the suction device
c. Provide oral hygiene care
d. Replace the NG tube
Answer: b. Evaluate functioning of the suction device
Verified Rationale: Vomiting may indicate NG tube clogging or suction malfunction causing gastric
distention. First priority is equipment assessment. Antiemetic, oral care, or tube replacement follows after
confirming function.
3. Case Study Scenario (NGN - Select All That Apply):
A nurse is initiating enteral feedings for a client with the following orders:
● Feeding: 1/2 strength Isocal 240 mL/hr via PEG tube
● Vital signs: Temp 37.2°C, HR 88/min, BP 118/74, RR 16/min, SpO2 96%
Select all appropriate interventions:
☐ Advance feeding rate by 10 mL/hr q4h if tolerated
☐ Check residual before each feeding and every 4 hours
☐ Elevate HOB 30-45° during feeding
☐ Flush tubing with 30 mL water after each feeding
☐ Assess bowel sounds prior to initiation
Answer: ☐ Check residual before each feeding and every 4 hours | ☐ Elevate HOB 30-45°
, during feeding | ☐ Flush tubing with 30 mL water after feeding**
Verified Rationale: Residual prevents aspiration, HOB elevation reduces reflux risk, flushing
prevents clogging. Rate advancement requires tolerance first. Bowel sounds alone insufficient for
initiation.
4. While performing a routine assessment, a nurse notices
formula leaking around the client's PEG tube. Which of the
following actions should the nurse take first? (NCLEX -
Multiple Choice)
a. Initiate a requisition for tube replacement
b. Report leakage to the provider
c. Cleanse site and apply occlusive dressing
d. Assess stoma measurement
Answer: d. Assess stoma measurement
Verified Rationale: First assess if tube migrated (balloon deflation/leakage). Replacement requisition
premature without assessment. Cleaning follows measurement. Provider notification after initial
assessment.
5. A nurse is calculating tube feeding for a client weighing 70
kg. Order: 25 kcal/kg/day, 1.5 g protein/kg/day. Approximate
volume of 1 kcal/mL formula needed daily?
a. 1500 mL
b. 1750 mL
c. 2000 mL
d. 2250 mL
Answer: b. 1750 mL
Verified Rationale: 70 kg × 25 kcal/kg = 1750 kcal needed. 1750 kcal ÷ 1 kcal/mL = 1750 mL formula
daily.
6. Client has NG tube order: Jevity 1.5 (1.5 kcal/mL) at 60
mL/hr continuous. Daily kcal intake?
a. 1440 kcal
b. 1800 kcal
c. 2160 kcal
d. 2520 kcal
Answer: c. 2160 kcal
Verified Rationale: 60 mL/hr × 24 hr × 1.5 kcal/mL = 2160 kcal/day.
