LPN Therapeutic Diets and Enteral Feedings 5 — Questions and Answers
Question 1: The LPN is preparing to flush a jejunostomy tube. Which solution is recommended for routine tube flushes?
- Normal saline
- Sterile water
- Tap water (for adults with intact immune systems) (Correct answer)
- Cranberry juice to prevent clogging
Correct answer: Tap water (for adults with intact immune systems)
Tap water is generally acceptable for flushing feeding tubes in immunocompetent adults; sterile water is used for immunocompromised patients or jejunostomy tubes per facility policy.
Question 2: A patient with COPD requires nutritional support. Which dietary modification is most appropriate to reduce carbon dioxide production?
- High-carbohydrate, low-fat diet
- High-fat, lower-carbohydrate diet (Correct answer)
- High-protein, high-carbohydrate diet
- Low-calorie liquid diet only
Correct answer: High-fat, lower-carbohydrate diet
High-fat, lower-carbohydrate diets reduce CO2 production from carbohydrate metabolism, which eases the respiratory burden in COPD patients.
Question 3: When initiating continuous enteral feedings, the LPN should start at what rate and advance how?
- Full goal rate immediately to meet nutritional needs
- Low rate (10–20 mL/hr) and increase gradually as tolerated per orders (Correct answer)
- Half the goal rate for 12 hours then discontinue
- Intermittent bolus only, never continuous
Correct answer: Low rate (10–20 mL/hr) and increase gradually as tolerated per orders
Starting at a low rate and advancing gradually allows the GI tract to adjust and helps prevent intolerance symptoms like nausea and diarrhea.
Question 4: A patient on a fluid-restricted diet due to hyponatremia asks if gelatin (Jell-O) is allowed. The LPN correctly responds:
- Yes, gelatin is not counted as a fluid
- No, gelatin is counted as a fluid because it is liquid at room temperature (Correct answer)
- Yes, only small amounts of gelatin are restricted
- No, gelatin is restricted only for diabetic patients
Correct answer: No, gelatin is counted as a fluid because it is liquid at room temperature
Any food that is liquid at room temperature, including gelatin, ice cream, and ice chips, counts toward fluid restrictions.
Question 5: The LPN is caring for a patient with a new PEG tube. What is the earliest the skin around the PEG site should be cleaned?
- Immediately after insertion
- 24 hours after insertion using soap and water as ordered (Correct answer)
- Only when visible soiling is present
- One week after insertion to allow healing
Correct answer: 24 hours after insertion using soap and water as ordered
PEG site care typically begins 24 hours post-insertion using soap and water to prevent infection while allowing initial healing.
Question 6: A patient receiving enteral nutrition develops hyperglycemia. Which nursing action is the priority?
- Discontinue feedings immediately
- Monitor blood glucose per orders and notify the provider for management (Correct answer)
- Switch to a high-fiber formula without notifying the provider
- Administer insulin without an order to correct the glucose
Correct answer: Monitor blood glucose per orders and notify the provider for management
Hyperglycemia during enteral feeding should be documented, monitored per orders, and reported to the provider who will determine appropriate management.
Question 7: Which dietary modification is most appropriate for a patient with iron-deficiency anemia?
- Increase calcium-rich foods with each meal
- Increase heme iron foods and consume vitamin C with iron-rich meals (Correct answer)
- Restrict protein intake to reduce iron demand
- Take iron supplements with milk to improve absorption
Correct answer: Increase heme iron foods and consume vitamin C with iron-rich meals
Heme iron (from meat) is well-absorbed, and vitamin C enhances non-heme iron absorption; calcium and milk inhibit iron absorption.
LPN Therapeutic Diets and Enteral Feedings 5
The LPN is preparing to flush a jejunostomy tube.
Which solution is recommended for routine tube flushes?