CDN CDN Enteral & Parenteral Nutrition 1 — Questions and Answers
Question 1: Which enteral formula type is most appropriate for a patient with fat malabsorption requiring a high proportion of medium-chain triglycerides?
- Standard polymeric formula
- Semi-elemental formula (Correct answer)
- Intact protein formula
- Fiber-enriched formula
Correct answer: Semi-elemental formula
Semi-elemental formulas contain medium-chain triglycerides and partially hydrolyzed proteins that are better absorbed in patients with fat malabsorption.
Question 2: What is the primary indication for initiating parenteral nutrition (PN) in a hospitalized patient?
- Patient preference for IV nutrition
- Non-functional or inaccessible GI tract for more than 7 days (Correct answer)
- Mild dysphagia with adequate oral intake
- Need for supplemental vitamins
Correct answer: Non-functional or inaccessible GI tract for more than 7 days
PN is indicated when the GI tract is non-functional, inaccessible, or cannot meet nutritional needs enterally for an extended period.
Question 3: A patient on total parenteral nutrition (TPN) develops hyperglycemia. What is the first recommended intervention?
- Discontinue TPN immediately
- Switch to enteral nutrition
- Reduce dextrose concentration and initiate insulin protocol (Correct answer)
- Increase lipid percentage in TPN
Correct answer: Reduce dextrose concentration and initiate insulin protocol
Reducing dextrose content and starting an insulin protocol is the standard first-line management for TPN-associated hyperglycemia.
Question 4: Which access route is preferred for long-term enteral nutrition in a patient with a functional stomach?
- Nasogastric tube
- Nasoduodenal tube
- Percutaneous endoscopic gastrostomy (PEG) (Correct answer)
- Nasojejunal tube
Correct answer: Percutaneous endoscopic gastrostomy (PEG)
A PEG tube is preferred for long-term enteral feeding (>4 weeks) in patients with a functional stomach as it is more comfortable and stable.
Question 5: Refeeding syndrome in a malnourished patient initiating PN is primarily caused by a shift in which electrolyte?
- Sodium
- Calcium
- Phosphorus (Correct answer)
- Magnesium
Correct answer: Phosphorus
Refeeding syndrome is primarily characterized by a rapid intracellular shift of phosphorus, leading to hypophosphatemia as anabolism resumes.
Question 6: What is the standard hang time for an open enteral formula system to prevent microbial contamination?
- 2 hours
- 4 hours
- 8 hours (Correct answer)
- 12 hours
Correct answer: 8 hours
Open enteral feeding systems should not hang for more than 8 hours to minimize the risk of bacterial contamination and formula degradation.
CDN CDN Enteral & Parenteral Nutrition 1
Which enteral formula type is most appropriate for a patient with fat malabsorption requiring a high proportion of medium-chain triglycerides?