This quiz will test your knowledge of parenteral vs. enteral nutrition, including the differences between each type, indications, complications, and nursing interventions. Nutrition support is essential for patients who cannot meet their nutritional needs through a regular diet. Nurses must understand the differences between enteral and parenteral nutrition to provide safe care and monitor for potential complications.
Enteral nutrition provides nutrients through the gastrointestinal (GI) tract using feeding tubes, while parenteral nutrition delivers nutrients directly into the bloodstream through an intravenous (IV) line. Each method has different administration routes, nursing considerations, and risks that nurses must recognize.
Don’t forget to watch the lecture on Parenteral vs. Enteral Nutrition (coming soon) before taking the quiz.
Parenteral vs Enteral Nutrition NCLEX Questions (TPN & Tube Feeding Nursing Review)
Parenteral vs Enteral Nutrition NCLEX Questions (TPN & Tube Feeding Nursing Review)
- Select the statements that are FALSE regarding parenteral and enteral nutrition (select all that apply):
A. Parenteral nutrition is nutrition delivered outside the GI tract.
B. TPN and PPN are types of enteral nutrition.
C. Enteral nutrition can be given through a peripheral or central intravenous line.
D. A patient with a nasoduodenal feeding tube is receiving enteral nutrition.
The answers are B and C. These statements are false because TPN and PPN are types of parenteral nutrition, not enteral nutrition, and enteral nutrition is delivered through the GI tract, not an IV line. Statement A is true because parenteral nutrition provides nutrients outside the GI tract. Statement D is true because a nasoduodenal tube delivers nutrition into the GI tract, making it enteral nutrition.
- The patient is receiving tube feeding through a tube that has been inserted through the nose and into the first part of the small intestine. What type of feeding tube is this?
A. nasogastric
B. jejunostomy
C. nasoduodenal
D. nasojejunal
The answer is C: nasoduodenal. A nasoduodenal tube is a small-bore tube used for enteral feedings that delivers nutrition directly into the GI tract. The first part of the small intestine is the duodenum, and the second part is the jejunum (do not confuse these two areas). When using this tube, monitor for tube placement, feeding intolerance, and signs of complications such as aspiration, abdominal distention, or diarrhea.
- Which of the following is not a typical complication of parenteral nutrition?
A. hypoglycemia
B. aspiration
C. refeeding syndrome
D. electrolyte imbalance
The answer is B: aspiration. Aspiration occurs when food, fluid, or stomach contents enter the airway and lungs. This is a major concern with enteral nutrition because feedings are delivered through the GI tract. Parenteral nutrition bypasses the GI tract, so the main concerns include glucose shifts (high or low blood glucose), infection, fluid and electrolyte imbalances, and refeeding syndrome.
- A severely malnourished patient has just started receiving enteral nutrition. Which complication is the patient at greatest risk for?
A. toxic megacolon
B. refeeding syndrome
C. dehydration
D. dumping syndrome
The answer is B: refeeding syndrome. Refeeding syndrome occurs when nutrition is restarted in a severely malnourished patient, causing a sudden shift of electrolytes into the cells as the body begins using nutrients again. The hallmark finding is hypophosphatemia (low phosphorus levels). Other complications listed are not the primary concern when starting nutrition in a severely malnourished patient.
- A patient receiving parenteral nutrition is at risk for refeeding syndrome. The nurse knows which finding is most commonly associated with this syndrome.
A. low phosphate level
B. high phosphate level
C. high glucose level
D. low sodium level
The answer is A: low phosphate. Refeeding syndrome occurs when nutrition is restarted after severe malnutrition, causing nutrients like glucose to move into cells and pull electrolytes with them. This causes phosphate levels to drop, which is the hallmark finding. Potassium and magnesium can also decrease because they shift into the cells.
- Which finding indicates that a patient is an appropriate candidate for enteral nutrition via a nasojejunal tube?
A. paralytic ileus
B. basilar skull fracture
C. esophageal varices
D. stroke
The answer is D: stroke. A stroke patient may have difficulty swallowing (dysphagia) and may need enteral nutrition through a nasojejunal tube to provide nutrition while reducing aspiration risk. A paralytic ileus prevents proper GI movement, a basilar skull fracture makes nasal tube placement unsafe, and esophageal varices increase the risk of bleeding.
- A patient is prescribed total parenteral nutrition (TPN). Which route should the nurse use to administer this type of nutrition?
A. Gastrostomy tube
B. Central venous catheter
C. Peripheral intravenous line
D. Nasogastric tube
The answer is B: central venous catheter. TPN is given through a central line because the solution is very hypertonic and can cause severe tissue damage if it leaks into surrounding tissues. It is typically administered into the superior vena cava, where high blood flow helps dilute the solution.
- The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which nursing action places the patient at MOST risk for rebound hypoglycemia?
A. Abruptly stopping the TPN
B. Tapering off the TPN too slowly
C. Administering the nutrition too rapidly
D. Administering the nutrition too slowly
The answer is A: abruptly stopping the TPN. TPN contains a high amount of glucose, so stopping it suddenly can cause rebound hypoglycemia, which is a rapid drop in blood glucose after the body has become dependent on the glucose infusion. Tapering off the TPN slowly (option B) helps prevent this complication. Administering TPN too rapidly (option C) can increase the risk of refeeding syndrome, especially in severely malnourished patients. Administering TPN too slowly (option D) is not associated with rebound hypoglycemia.
- While a patient is receiving total parenteral nutrition (TPN), which assessment should the nurse prioritize?
A. Keeping the head of the bed elevated at 30–45 degrees at all times
B. Flushing the tube with water per protocol to prevent clogging
C. Checking gastric residual volume before starting feedings
D. Assessing blood glucose levels per protocol
The answer is D: assessing blood glucose levels per protocol. TPN is a hypertonic solution that contains high amounts of glucose, so blood glucose levels must be monitored regularly to detect complications such as hyperglycemia or hypoglycemia. Glucose should be monitored daily per protocol, even in patients without diabetes. Other priorities include monitoring for infection at the catheter site. Options A, B, and C are related to enteral feedings, not TPN.
- True or False: TPN is more concentrated and has a higher osmolarity than PPN.
The answer is TRUE.
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