Chapter 32 Parenteral Nutrition

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Chapter 32  Parenteral Nutrition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. A 72-year-old patient is admitted to the hospital with a medical diagnosis of intestinal failure. Which intervention should the nurse include in the plan of care to deliver nutritional needs?
a.
Enteral
b.
Parenteral
c.
A combination of enteral and parenteral
d.
Oral

ANS: B
In situations where partial or complete intestinal failure has occurred and oral nutrition or enteral tube feeding is not possible, parenteral nutrition (PN) is the therapy of choice. When a patient’s gastrointestinal (GI) tract is functional, clinicians assess the patient and choose the best method of delivering nutritional needs, which may include enteral feeding, parenteral feeding, or a combination of both.

DIF: Cognitive Level: Analysis REF: Text reference: pp. 796-797
OBJ: Identify patients who are candidates for parenteral nutrition.
TOP: Parenteral Nutrition KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. The patient has been ordered to receive parenteral nutrition but will require the nutritional therapy to continue for several months. Which route is most important for the nurse to consider?
a.
Second intravenous line
b.
Enteral feeding tube
c.
Central venous access device
d.
Parenteral feeding tube

ANS: C
The ideal method to administer PN over an extended period is through a central venous catheter, which allows for higher concentration of nutrients.

DIF: Cognitive Level: Analysis REF: Text reference: p. 800
OBJ: Describe factors influencing the selection of appropriate sites for administering parenteral nutrition. TOP: Central Lines
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

3. The nurse is caring for a patient who is receiving PN. As part of therapy, the patient undergoes routine bedside glucose monitoring that reveals which expected outcome?
a.
Lower than normal blood glucose to determine adequate tolerance for PN
b.
Slightly higher than normal blood glucose to meet increased cellular needs
c.
Slightly higher than normal blood glucose to prevent infection or systemic sepsis
d.
Normal blood glucose to prevent associated complications

ANS: D
For PN to be used safely, its administration must be closely monitored. Special care is necessary to maintain blood glucose levels in the normal range. Higher glucose levels are often associated with cardiovascular events, general infection, systemic sepsis, acute renal failure, and death.

DIF: Cognitive Level: Analysis REF: Text reference: pp. 798-799
OBJ: Discuss risks associated with parenteral nutrition. TOP: Blood Sugar Control
KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity

4. A patient had surgery 1 week ago, has not been eating his meals, and states that he has no appetite. The nurse assesses that the patient has been progressively losing weight. Which intervention has the highest priority?
a.
Encouraging the patient to eat
b.
Force-feeding the patient
c.
Consulting with the nutritional support team
d.
Being aware that the patient will come around when hungry

ANS: C
Frequently, the nurse will be the first to identify risk factors, such as progressive weight loss, restricted or limited fluid intake, intolerance to enteral feedings, increased energy need (burns, sepsis, and trauma), and being NPO (nothing by mouth) for 3 or more days. The first sign of a developing problem is a pattern of a decline in oral food intake and reduced appetite. Assessment provides information for consulting with the nutritional support team and the physician in an effort to initiate appropriate PN. Force-feeding the patient may only lead to worse issues, especially if the patient has a nonfunctioning intestinal system.

DIF: Cognitive Level: Analysis REF: Text reference: pp. 799-801
OBJ: Identify patients who are candidates for parenteral nutrition.
TOP: Nutritional Support Team KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

 

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