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 Question 11 The nurse is assessing a patient’s ability to receive enteral feedings. Which findings would the nurse evaluate as potential contraindications to this intervention? 1. The patient has a history of Crohn’s disease. 2. The patient has a gastric ulcer. 3. There is a mechanical obstruction. 4. The patient has developed hemorrhagic pancreatitis. 5. The patient has had severe intractable diarrhea for 3 days. Question 12 A patient, with a history of aspiration pneumonia, is going to receive enteral feedings. What should be considered regarding the tube and placement for this patient? 1. Postpyloric feedings need to be interrupted and would not support the patient’s nutritional needs. 2. Postpyloric feedings have less incidence of pneumonia in some groups and would be preferred for this patient. 3. Gastric feedings provide more calories and better tolerance. 4. Gastric feedings are ideal as long as the patient is receiving a proton pump inhibitor. Question 13 A patient receiving nasogastric tube feedings has a gastric residual volume of 450 mL. Which nursing intervention is indicated? 1. Hold the tube feeding until the gastric aspirate is less than 100 mL. 2. Provide the tube feeding as a bolus. 3. Hold the tube feeding until the gastric aspirate is less than 250 mL. 4. Provide the tube feeding as a continuous infusion. Question 14 A patient has a clogged postpyloric feeding tube. Which nursing intervention is indicated? 1. Irrigate the tube with a large amount of pressure to break the clog. 2. Pull the tube and insert another. 3. Slowly attempt to irrigate the tube with warm water. 4. Use a stylet to break through the clog. Question 15 The nurse is caring for a patient with a large bore catheter for total parenteral nutrition. Which findings would indicate to the nurse that the patient might be experiencing catheter related sepsis? 1. Sudden glucose intolerance 2. Leukocytosis 3. Sudden onset of chills 4. Sudden onset chest pain 5. Tenderness at the insertion site   Question 16 A patient receiving total parenteral nutrition has elevated serum blood urea nitrogen and serum sodium levels. The nurse would conduct additional assessment for which complication? 1. Prerenal azotemia 2. Hyperglycemia 3. Catheter related sepsis 4. Hepatic dysfunction Question 17 After the insertion of a central venous catheter for total parenteral nutrition, the patient demonstrates dyspnea. The nurse is concerned that pneumothorax may be occurring. Which assessment findings would support this concern? 1. Restlessness 2. Chest pain 3. Decrease in pulse oximetry reading 4. Severe headache 5. Combativeness Question 18 A patient is suspected of having an air emboli from a central venous line inserted for total parenteral nutrition. What nursing interventions are indicated? 1. Place the patient on the left side. 2. Place the patient in Trendelenburg position. 3. Occlude the catheter nearest to the entry site of the skin. 4. Notify the physician and prepare to take the patient to surgery. 5. Prepare to assist with chest tube insertion. Question 19 The nurse is concerned that refeeding syndrome may be occurring in a patient receiving enteral nutrition. Which laboratory values would support this concern? 1. Serum potassium is 3.4 mEq/L 2. Fasting blood glucose is 98mg/dL 3. Hemoglobin is 10.8 g/100mL 4. Serum sodium of 138 mEq/L 5. Chloride of 98 mmol/L Question 20 A patient has been started on tube feeding by nasogastric tube. When his wife visits she says, “I need to tell you that my husband is lactose intolerant so that feeding will make him sick.” What nursing response is indicated? 1. “Even though the tube feeding fluid looks like milk it is lactose-free.” 2. “We did not know that. I will contact his physician immediately.” 3. “Since he is being fed by tube, the fact that he is lactose intolerant is not an issue.” 4. “We will watch to see if he has any symptoms of lactose intolerance.”