LPN Therapeutic Diets and Enteral Feedings 4 — Questions and Answers
Question 1: A patient develops diarrhea 24 hours after starting enteral feedings. Which intervention should the LPN implement first?
- Increase the feeding rate to replace lost fluids
- Assess for infection, medications, and formula concentration as causes (Correct answer)
- Discontinue feedings permanently
- Switch to oral intake immediately
Correct answer: Assess for infection, medications, and formula concentration as causes
Diarrhea during enteral feedings has multiple causes including hyperosmolar formula, infection, or medications; assessment guides the appropriate intervention.
Question 2: The LPN is teaching a patient with gout about dietary modifications. Which food should the patient be instructed to limit?
- Low-fat dairy products
- Organ meats and shellfish (Correct answer)
- Fresh vegetables and fruits
- Whole grain breads
Correct answer: Organ meats and shellfish
Organ meats and shellfish are high in purines, which metabolize to uric acid and can trigger gout attacks.
Question 3: A patient's nasogastric tube feeding is infusing by gravity drip. The LPN notes the drip rate has slowed. Which action is appropriate?
- Increase head-of-bed elevation to 90 degrees
- Flush the tube with 30 mL of warm water and recheck patency (Correct answer)
- Aspirate vigorously with a 60 mL syringe
- Replace the NG tube immediately
Correct answer: Flush the tube with 30 mL of warm water and recheck patency
Flushing with warm water helps clear partial tube occlusion and restore patency without damaging the tube or gastric mucosa.
Question 4: Which therapeutic diet is appropriate for a patient in the early post-operative period following bowel surgery?
- High-fiber diet
- Clear liquid diet progressing to regular as tolerated (Correct answer)
- High-protein, high-calorie diet from day one
- Pureed diet with added fiber supplements
Correct answer: Clear liquid diet progressing to regular as tolerated
Post-operative bowel surgery patients typically begin with clear liquids and advance gradually as bowel function returns to prevent complications.
Question 5: A patient on warfarin therapy asks about vitamin K intake. The LPN correctly explains that the patient should:
- Eliminate all vitamin K from the diet immediately
- Keep vitamin K intake consistent from day to day (Correct answer)
- Increase vitamin K-rich foods to boost anticoagulation
- Avoid all green vegetables permanently
Correct answer: Keep vitamin K intake consistent from day to day
Consistent daily vitamin K intake helps maintain stable INR levels, as fluctuations in intake can alter warfarin's anticoagulant effect.
Question 6: The LPN notes the enteral feeding formula container has been hanging for 10 hours. What should the LPN do?
- Continue the infusion since it has not expired yet
- Discard the formula and replace with a fresh container per policy (Correct answer)
- Refrigerate the remaining formula and resume later
- Add more formula to the partially full container
Correct answer: Discard the formula and replace with a fresh container per policy
Open enteral formula containers should not hang for more than 4–8 hours (per manufacturer and facility policy) due to risk of bacterial contamination.
Question 7: A patient with liver cirrhosis is placed on a protein-restricted diet. The LPN knows this restriction is intended to reduce:
- Blood glucose levels
- Serum ammonia levels and risk of hepatic encephalopathy (Correct answer)
- Fluid retention and ascites
- Serum triglyceride levels
Correct answer: Serum ammonia levels and risk of hepatic encephalopathy
Protein restriction in cirrhosis reduces ammonia production from protein metabolism, decreasing the risk of hepatic encephalopathy.
LPN Therapeutic Diets and Enteral Feedings 4
A patient develops diarrhea 24 hours after starting enteral feedings.
Which intervention should the LPN implement first?