CN Clinical Procedures & Protocols 3 — Questions and Answers
Question 1: A hospitalized patient on continuous enteral feeding requires water flushes primarily to:
- Maintain tube patency and meet hydration needs (Correct answer)
- Increase caloric density of the formula
- Slow gastric emptying
- Reduce protein requirements
Correct answer: Maintain tube patency and meet hydration needs
Routine water flushes prevent tube clogging and contribute to the patient's daily fluid requirements.
Question 2: When calculating estimated energy needs with the Mifflin-St Jeor equation, which variables are required?
- Weight, height, age, and sex (Correct answer)
- Weight, activity level, and blood glucose
- Height, waist circumference, and body fat percentage
- Age, sex, and serum albumin
Correct answer: Weight, height, age, and sex
Mifflin-St Jeor estimates resting metabolic rate from weight, height, age, and sex before applying activity or stress factors.
Question 3: A patient receiving parenteral nutrition should have blood glucose monitored regularly primarily because PN solutions:
- Contain high concentrations of dextrose that can cause hyperglycemia (Correct answer)
- Are protein-free
- Contain no carbohydrate
- Always cause hypoglycemia
Correct answer: Contain high concentrations of dextrose that can cause hyperglycemia
The dextrose load in parenteral nutrition frequently causes hyperglycemia, which worsens infection risk and outcomes.
Question 4: Which screening tool is specifically validated to identify malnutrition risk in adults aged 65 and older?
- Mini Nutritional Assessment (MNA) (Correct answer)
- Tanner staging
- Braden scale
- Glasgow Coma Scale
Correct answer: Mini Nutritional Assessment (MNA)
The MNA was developed and validated for nutritional risk screening in older adults.
Question 5: To minimize aspiration risk during gastric enteral feeding, standard protocol is to keep the head of the bed elevated at least:
- 30 to 45 degrees (Correct answer)
- 5 to 10 degrees
- 90 degrees at all times
- 0 degrees (flat)
Correct answer: 30 to 45 degrees
Elevating the head of the bed 30-45 degrees during and after feeding reduces reflux and aspiration risk.
Question 6: During a follow-up visit, a nutritionist documents 'patient will consume 25 grams of fiber daily within 4 weeks.' In an ADIME note, this belongs under:
- Intervention (goal setting) (Correct answer)
- Assessment
- Diagnosis
- Monitoring lab section only
Correct answer: Intervention (goal setting)
Specific, measurable patient goals are documented within the intervention component of the ADIME framework.
Question 7: Unintentional loss of what percentage of usual body weight in 6 months is a commonly used threshold indicating severe nutritional risk?
- Greater than 10% (Correct answer)
- 1%
- 2%
- 50%
Correct answer: Greater than 10%
Unintentional weight loss exceeding 10% of usual body weight over 6 months signals significant malnutrition risk.
CN Clinical Procedures & Protocols 3
A hospitalized patient on continuous enteral feeding requires water flushes primarily to: