Registered Dietitian Nutritionist Enteral & Parenteral Nutrition Support 1 — Questions and Answers
Question 1: What is the primary indication for initiating enteral nutrition support?
- Patient has a functioning GI tract but cannot meet needs orally (Correct answer)
- Patient requires immediate caloric repletion via intravenous route
- Patient has complete intestinal failure with no GI function
- Patient has severe mechanical bowel obstruction
Correct answer: Patient has a functioning GI tract but cannot meet needs orally
Enteral nutrition is indicated when the GI tract is functional but oral intake is insufficient to meet nutritional needs — the 'if the gut works, use it' principle.
Question 2: Which enteral feeding route is preferred for short-term nutrition support expected to last fewer than 4–6 weeks?
- Percutaneous endoscopic gastrostomy (PEG)
- Jejunostomy tube (J-tube)
- Nasogastric (NG) tube (Correct answer)
- Gastrostomy tube (G-tube)
Correct answer: Nasogastric (NG) tube
Nasogastric tubes are preferred for short-term enteral access because they are easily placed without surgery or endoscopy.
Question 3: What is the standard caloric density of most isotonic enteral formulas?
- 0.5 kcal/mL
- 1.0 kcal/mL (Correct answer)
- 1.5 kcal/mL
- 2.0 kcal/mL
Correct answer: 1.0 kcal/mL
Standard isotonic enteral formulas provide 1.0 kcal/mL, suitable for patients with normal fluid and caloric requirements.
Question 4: Which of the following is an absolute contraindication for enteral nutrition?
- Mild-to-moderate acute pancreatitis
- Dysphagia with aspiration risk
- Mechanical bowel obstruction (Correct answer)
- Short bowel syndrome with residual small intestine
Correct answer: Mechanical bowel obstruction
Mechanical bowel obstruction prevents normal GI transit, making any enteral feeding contraindicated until the obstruction is resolved.
Question 5: To reduce aspiration risk during continuous enteral feeding, the head of the bed should be elevated to at least:
- 0–15 degrees
- 15–25 degrees
- 30–45 degrees (Correct answer)
- 60–90 degrees
Correct answer: 30–45 degrees
Elevating the head of the bed to 30–45 degrees uses gravity to reduce gastric reflux and lower aspiration risk during enteral feeding.
Question 6: Elemental or semi-elemental enteral formulas are most appropriate for patients with:
- Normal GI function and high caloric demands
- Diabetes mellitus requiring carbohydrate restriction
- Renal failure with fluid volume restrictions
- Impaired digestion or absorption such as short bowel syndrome or pancreatitis (Correct answer)
Correct answer: Impaired digestion or absorption such as short bowel syndrome or pancreatitis
Elemental/semi-elemental formulas contain pre-digested (hydrolyzed) nutrients that require minimal digestive work, making them ideal for GI malabsorption states.
Question 7: Which electrolyte imbalance is the hallmark metabolic abnormality of refeeding syndrome?
- Hypernatremia
- Hyperkalemia
- Hypophosphatemia (Correct answer)
- Hypercalcemia
Correct answer: Hypophosphatemia
Refeeding syndrome is characterized by severe hypophosphatemia caused by rapid intracellular uptake of phosphate when anabolic metabolism resumes after prolonged starvation.
Registered Dietitian Nutritionist Enteral & Parenteral Nutrition Support 1
What is the primary indication for initiating enteral nutrition support?