CSG CSG Enteral & Parenteral Nutrition Support 1 — Questions and Answers
Question 1: Enteral nutrition is preferred over parenteral nutrition for older adults primarily because:
- It is less expensive and easier to administer
- It maintains gut integrity and reduces infection risk (Correct answer)
- It requires no monitoring of electrolytes
- It provides higher caloric density
Correct answer: It maintains gut integrity and reduces infection risk
Enteral nutrition preserves intestinal mucosal integrity, promotes gut immunity, and reduces the risk of bacterial translocation and catheter-related bloodstream infections compared to parenteral nutrition.
Question 2: Which tube feeding route is MOST appropriate for an older adult who requires long-term enteral nutrition (greater than 4 weeks)?
- Nasogastric tube
- Orogastric tube
- Percutaneous endoscopic gastrostomy (PEG) tube (Correct answer)
- Nasojejunal tube
Correct answer: Percutaneous endoscopic gastrostomy (PEG) tube
PEG tubes are indicated for long-term enteral nutrition beyond 4 weeks as they are more comfortable, lower aspiration risk, and allow patients greater mobility than nasogastric tubes.
Question 3: Refeeding syndrome is a life-threatening complication of initiating nutrition support in malnourished older adults characterized by a sudden drop in which electrolyte?
- Sodium
- Phosphorus (Correct answer)
- Calcium
- Magnesium only
Correct answer: Phosphorus
Refeeding syndrome is defined by hypophosphatemia occurring when carbohydrate reintroduction shifts phosphorus intracellularly, causing cardiac arrhythmias, respiratory failure, and neurological complications.
Question 4: A continuous tube feeding regimen is preferred over bolus feeding for older adults with:
- Good gastric motility and no aspiration risk
- High aspiration risk or impaired gastric emptying (Correct answer)
- Diabetes requiring tight glycemic control
- Preference for mealtime eating patterns
Correct answer: High aspiration risk or impaired gastric emptying
Continuous feeding at a slow rate reduces gastric residual volumes and aspiration risk in older adults with delayed gastric emptying or history of aspiration.
Question 5: Which laboratory value is MOST important to monitor when initiating parenteral nutrition in an older adult?
- Serum albumin
- Blood glucose (Correct answer)
- Serum ferritin
- Urine creatinine
Correct answer: Blood glucose
Blood glucose must be closely monitored during parenteral nutrition initiation because dextrose infusion frequently causes hyperglycemia, which worsens outcomes in critically ill older adults.
Question 6: Aspiration risk during enteral feeding can be reduced by:
- Feeding the patient in a supine (flat) position
- Elevating the head of the bed to 30–45 degrees during and after feeding (Correct answer)
- Using higher-viscosity formula
- Administering feeding rapidly to minimize time at risk
Correct answer: Elevating the head of the bed to 30–45 degrees during and after feeding
Elevating the head of the bed to 30–45 degrees uses gravity to keep gastric contents from refluxing into the esophagus and airways during enteral feeding.
CSG CSG Enteral & Parenteral Nutrition Support 1
Enteral nutrition is preferred over parenteral nutrition for older adults primarily because: