Basic Nursing Skills Nutrition & Fluid Balance 2 — Questions and Answers
Question 1: Which electrolyte imbalance is most associated with muscle cramps, weakness, and cardiac dysrhythmias?
- Hypocalcemia
- Hyponatremia
- Hypokalemia (Correct answer)
- Hyperphosphatemia
Correct answer: Hypokalemia
Hypokalemia (low potassium) causes muscle weakness, cramps, fatigue, and dangerous cardiac dysrhythmias including U waves on ECG.
Question 2: Before inserting a nasogastric (NG) tube, the nurse should:
- Measure from the nose to the xiphoid process
- Measure from the nose to the ear to the xiphoid process (Correct answer)
- Measure from the mouth to the navel
- Estimate the length using the patient's height
Correct answer: Measure from the nose to the ear to the xiphoid process
The NEX measurement (nose to ear to xiphoid process) estimates the length of tubing needed to reach the stomach.
Question 3: After inserting an NG tube, the most reliable method to verify placement is:
- Aspirating gastric contents and checking pH
- Auscultating air insufflation over the stomach
- Observing the patient for coughing or choking
- Confirming placement with an X-ray (Correct answer)
Correct answer: Confirming placement with an X-ray
Radiographic confirmation (X-ray) is the gold standard for verifying NG tube placement before initiating feedings or medications.
Question 4: A patient receiving enteral tube feedings develops abdominal distension, nausea, and high gastric residual volumes. The nurse should:
- Increase the feeding rate to meet nutritional goals
- Hold the feeding and notify the provider (Correct answer)
- Switch to a different formula immediately
- Continue feeding and recheck in 4 hours
Correct answer: Hold the feeding and notify the provider
High gastric residual volumes with abdominal distension and nausea suggest intolerance or aspiration risk; tube feedings should be held and the provider notified.
Question 5: Which dietary teaching point is most important for a patient with newly diagnosed type 2 diabetes?
- Eliminate all carbohydrates from the diet
- Distribute carbohydrate intake evenly throughout the day (Correct answer)
- Increase protein intake to 50% of total calories
- Avoid all fats and oils
Correct answer: Distribute carbohydrate intake evenly throughout the day
Consistent carbohydrate distribution throughout the day helps maintain stable blood glucose levels in patients with type 2 diabetes.
Question 6: A patient's intake and output record shows 2,800 mL intake and 1,200 mL output in 24 hours. The nurse should recognize this as:
- Normal fluid balance
- Fluid deficit requiring IV fluids
- Positive fluid balance indicating potential overload (Correct answer)
- Negative fluid balance
Correct answer: Positive fluid balance indicating potential overload
A positive fluid balance of 1,600 mL (intake 2,800 − output 1,200) indicates fluid retention, which may cause overload if prolonged.
Basic Nursing Skills Nutrition & Fluid Balance 2
Which electrolyte imbalance is most associated with muscle cramps, weakness, and cardiac dysrhythmias?