Enteral Nutrition in Clinical Practice: Exam Questions and Answers, Exams of Medicine

Download Enteral Nutrition in Clinical Practice: Exam Questions and Answers and more Exams Medicine in PDF only on Docsity! CNSC Exam Module III A Questions And Answers Once the Enteral formula is opened, how long may it be stored in a refrigerator? a. up to 24 hours b. up to 36 hours c. up to 48 hours d. up to 72 hours - correct answer ✅c. up to 48 hours Which of the following is not an accepted means for estimating daily fluid requirements in enterally-fed adult patients? a. 0.5 mL/kg/min b. 35 mL/kg/day c. 1500 mL/m body surface area/24 hours d. 1 mL/kcal consumed - correct answer ✅A. 0.5 mL/kg/min 51.5 kg afebrile 55-year old female with dysphagia is started on a standard 1.0 kcal/mL enteral formula with 85% water at 180 mL/hr over 10 hours nightly. Which of the following water flush regimens would best meet her daily estimated fluid requirements? a. 0 mL b. 60 mL every 8 hours CNSC Exam Module III A Questions And Answers c. 90 mL every 8 hours d. 120 mL every 8 hours - correct answer ✅c. 90 mL every 8 hours In studies comparing EN to PN patients with severe acute pancreatitis, which of the following potential benefits of EN over PN has not been documented? a. decrease hospitalization length b. decrease mortality c. decrease trend of organ failure d. decrease infection rate - correct answer ✅b. decrease mortality Which of the following is NOT a perceived benefit of early enteral feeding in critically ill patients? a. prevents the occurrence of translocation of gut bacteria b. reduces atrophy of intestinal villae c. fewer infectious complications than PN-fed patients d. increases intestinal permeability - correct answer ✅d. increases intestinal permeability Which of the following parameters is not useful in assessing the efficacy of enteral nutrition in pregnancy? CNSC Exam Module III A Questions And Answers c. It should be implemented on an emergency basis, regardless of patient's hemodynamic status d. It is commonly used to treat specific disease manifestations - correct answer ✅a. It may be implemented in patients who cannot, should not, or will not eat adequately Tube feedings can be effectively used in which of the following conditions? a. intractable nausea and vomiting b. high output proximal fistula c. open peritoneal cavity b. short bowel syndrome (<50 cm) without colon - correct answer ✅c. open peritoneal cavity Which of the following is an indication to surgically place a jejunostomy feeding tube? a. hyperemesis gravidarum b. dysphagia c. gastroesophageal reflux d. diabetic gastroparesis - correct answer ✅d. diabetic gastroparesis CNSC Exam Module III A Questions And Answers Which of the following is the most infasive method used to assist in placement of a nasoenteric feeding tube? a. corkscrew method b. direct fluoroscopic guidance c. endoscopic assistance d. pharmacologic stimulation - correct answer ✅c. endoscopic assistance How long should T-fasteners be left in place after placing a gastrostomy or jejunostomy feeding tube laparoscopically or radiologically? a. 4-5 days b. 10-14 days c. 21-24 days d. 28-31 days - correct answer ✅b. 10-14 days Which of the following is most characteristic of a skin- level device or a button for enteral feeding? a. can only be used with gastrostomies b. does not contain an antireflux valve c. can be capped at skin level when not in use CNSC Exam Module III A Questions And Answers d. can only be placed in the operating room - correct answer ✅c. can be capped at skin level when not in use What is the gold standard for determining proper position of a feeding tube placed at the bedside? a. radiographic confirmation b. pH testing for acidity of aspirates c. Aspiration of obvious gastric contents d. air sufflation and auscultation over the gastric bubble - correct answer ✅a. radiographic confirmation Which of the following is a contraindication to a percutaneous endoscopic jejunostomy tube? a. gastroparesis b. partial gastrectomy c. refractory celiac disease d. end-jejunostomy - correct answer ✅d. end-jejunostomy Compared to gastric feeding, small bowel feeding is associated with which of the following outcomes in critically ill patients? a. longer time to achieve target nutrition CNSC Exam Module III A Questions And Answers c. more successful delivery of calories d. reduced incidence of gastric perforation - correct answer ✅b. less nasal irritation Which of the following is a contraindication to a percutaneous endoscopic gastrostomy tube placement? a. ascites b. partial gastrectomy c. obesity d. stroke - correct answer ✅a. ascites Which of the following is NOT pre-procedural care of a patient undergoing placement of a percutaneous endoscopic gastrostomy tube? a. obtaining informed consent b. obtaining an abdominal x-ray c. administering an antibiotic on call d. confirming normal INR - correct answer ✅b. obtaining an abdominal x-ray Which of the following is the preferred method of feeding tube placement when post pyloric feeding is required for less than 4 weeks? CNSC Exam Module III A Questions And Answers a. laparoscopic b. open surgical c. nasal jejunal tube d. percutaneous endoscopic jejunostomy - correct answer ✅d. nasal jejunal tube What is the primary advantage of a direct percutaneous endoscopic placed jejunal tube versus a percutaneous endoscopic transgastric-placed jejunal tube? a. easier to place b. reduced incidence of bleeding c. reduced incidence of migration d. reduced incidence of gastric outlet obstruction - correct answer ✅c. reduced incidence of migration Which of the following types of enteral formulas is MOST likely to increase splanchnic blood flow in a critically ill patient? a. high fat b. high carbohydrate c. high fiber d. high osmolarity - correct answer ✅d. high osmolarity CNSC Exam Module III A Questions And Answers Hospital prepared enteral nutrition formulas should be stored at what temperature? a. 4 degrees C (39.2 degrees F) b. 6 degrees C (42.8 degrees F) c. 8 degrees C (46.4 degrees F) d. 10 degrees C (50.0 degrees F) - correct answer ✅a. 4 degrees C (39.2 degrees F) An isotonic formula has an osmolality of a. 150 mOsm/kg b. 300 mOsm/kg c. 450 mOsm/kg d. 600 mOsm/kg - correct answer ✅b. 300 mOsm/kg Which of the following best describes the initiation of a hypertonic formula for gastric feeding? a. formula can safely be initiation at full strength at a low rate b. formula should be diluted to an isotonic formula and initiated at goal rate c. formula should be co-administered with an anti- diarrheal agent CNSC Exam Module III A Questions And Answers Which of the following best describes the absorption of small peptides and free amino acids contained in hydrolyzed enteral formulas? a. The majority of small peptides and amino acids are absorbed through active transport across the gastric mucosa b. Free amino acid absorption occurs more rapidly than an equivalent mixture of small peptides c. Small peptide formulations have a higher osmolality and thereby less efficient absorption than free amino acid formulas d. Although absorption may differ, there are no established clinical advantages to the use of small peptide over free amino acid formulas or vice-versa. - correct answer ✅d. Although absorption may differ, there are no established clinical advantages to the use of small peptide over free amino acid formulas or vice-versa The use of enteral formulas with intact protein has been shown to be as effective as the use of free amino acid based formulas in promoting remission of: a. Crohn's disease b. gastrointestinal cancer c. pancreatitis d. hepatic encephalopathy - correct answer ✅a. Crohn's disease CNSC Exam Module III A Questions And Answers Which of the following patients is most likely to benefit from immunonutrition? a. septic trauma patient b. trauma patient with isolated orthopedic injuries c. medical intensive care unit patient d. trauma patient with abdominal and torso injuries - correct answer ✅d. trauma patient with abdominal and torso injuries Which of the following would be the most appropriate tube feeding formula for a patient with extensive second and third degree burns? a. high fat b. high nitrogen c. concentrated d. high fiber - correct answer ✅b. high nitrogen Length of stay and postoperative infection rates have been shown to DECREASE in surgical patients receiving tube-feeding formulas enriched with: a. arginine b. nucleotides CNSC Exam Module III A Questions And Answers c. ascorbic acid d. branched-chain amino acids - correct answer ✅a. arginine The enteral formula for individuals with pulmonary disease requiring mechanical ventilation should always be: a. based on individual tolerance and needs b. low fat, high carbohydrate c. fluid concentrated, low fat d. high fat, low carbohydrate - correct answer ✅a. based on individual tolerance and needs Modular products are added to the tube-feeding regimen to: a. prevent bacteria translocation b. increase the respiratory quotient c. increase calorie and protein content d. alter the ratio of vitamins to minerals - correct answer ✅c. increase calorie and protein content Early commencement of enteral feeding has been suggested to benefit ICU patients, reducing infectious