Module 7:Home Nutrition Support exam 2024 with 100% correct answers
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Course
Module 7:Home Nutrition Support
Institution
Module 7:Home Nutrition Support
When evaluating the home environment for a patient receiving parenteral nutrition, which of the following is required?
1: Access to telephone
2: Isolated infusion area
3: Back-up electrical generator
4: Dedicated refrigerator correct answersPatients receiving home parenteral nutrition require a...
When evaluating the home environment for a patient receiving parenteral nutrition, which of the
following is required?
1: Access to telephone
2: Isolated infusion area
3: Back-up electrical generator
4: Dedicated refrigerator correct answersPatients receiving home parenteral nutrition require a
home/cellular telephone or other means of contacting someone outside of the home in the event of a
medical emergency. The appropriate health care personnel or emergency center must be contacted as
soon as possible. If there is frequent interruption of electrical service, a back-up battery-powered
infusion pump may be needed. A back-up electrical generator is not required. While preferred, an
isolated infusion area and dedicated refrigerator are not required. However, an area that can be used for
supply storage is required.
Which of the following are considered the lowest risk candidates for initiation of parenteral nutrition
(PN) in the home setting?
1: infants.
2: teenagers.
3: dialysis patients.
4: diabetic patients. correct answersInfants, intravenous drug abusers, patients with diabetes, fluid and
electrolyte/acid-base disorders, and those at risk for refeeding syndrome may not be ideal candidates for
initiation of PN in the home setting. Patients with these conditions may need more frequent monitoring
and clinical assessment than can be managed at home. Teenagers are typically not thought to be at high
risk for problems when PN is initiated in the home setting.
Which of the following diagnoses would meet Medicare Part B coverage criteria to qualify a beneficiary
for home enteral nutrition?
1: Dysphagia
2: Aspiration pneumonia
3: Anorexia
,4: Malnutrition correct answersHome enteral nutrition is a covered Medicare Part B benefit for a patient
who has a permanent non-function or disease of the structures that normally permit food to reach the
small bowel or for a disease of the small bowel that impairs digestion and absorption of an oral diet. The
beneficiary must require tube feeding to provide sufficient nutrients to maintain weight and strength
commensurate with their overall health status. The patient's condition could be either anatomic, e.g.
obstruction due to head and neck cancer or reconstructive surgery, or due to a motility disorder, e.g.
severe dysphagia following a stroke. Enteral nutrition is not covered for patients with a functioning
gastrointestinal tract whose need for enteral nutrition is due to reasons such as anorexia or nausea.
Following initial certification of parenteral nutrition by Medicare, after what length of time is
recertification required?
1: 6 months
2: 1 year
3: 1 month
4: Never correct answersAfter initial certification for parenteral nutrition is obtained, recertification is
required after 6 months of therapy. The recertification process is used to document the patient's
continued need for therapy; additional recertifications may be requested on an individual basis.
Medicare reimbursement for home and community-based professional nutrition education services
provided by a registered dietitian is restricted to patients who
1: live alone.
2: have cancer.
3: are over the age of 65.
4: have diabetes or renal disease. correct answersAt this time Medicare reimbursement for home and
community-based professional nutrition education services provided by a registered dietitian with a
Medicare provider number, only covers patients with diabetes, pre-dialysis kidney disease, and those
who are post-kidney transplant. A patient whose doctor or other healthcare provider refers them for the
services also qualifies. Professional intervention/monitoring for home parenteral nutrition patients is not
a covered benefit under Medicare.
Managed care and private insurance companies often use which established criteria/guidelines when
approving coverage for home parenteral nutrition (HPN)?
1: Medicare criteria
2: State-funded Medicaid program criteria
3: Oley Foundation criteria
, 4: ASPEN Standards for Specialized Nutrition Support: Home Care Patients correct answersInsurance
coverage for home enteral nutrition (HEN) and HPN varies by type of program as well as individual plans.
Government programs(eg. Medicare and Medicaid) have strict coverage criteria and require detailed
history, tests and nutritional data to determine eligibility. Coverage policies and reimbursement for HEN
and HPN also vary with private payers and managed care organizations and frequently require
preauthorization or precertification. Most require that the therapy be medically necessary and the sole
source of nutrition. Many insurance policies establish their own criteria for EN and PN, while others
follow the guidelines for coverage set forth by Medicare.
The most common complication seen after percutaneous endoscopic gastrostomy (PEG) tube placement
is:
1: Buried bumper syndrome
2: Peristomal infection
3: Gastric ulceration
4: Colocutaneous fistulas correct answersPost-procedural complications present days to months after
placement. Infection around the insertion site is a relatively common post-procedural complication
reported in up to 30% of tubes placed. Buried bumper syndrome is a result of erosion of the internal
bolster into the gastric mucosa and occurs in 0.3-2.4% of patients. Ulceration of the gastric mucosa is
caused by excessive tension between the external and internal bolster which leads to erosion and
bleeding. This occurs in only 0.3-2.5% of cases. Colocutaneous fistulas occur when the colon is
inadvertently punctured during placement. It is extremely rare, occurring in only 0-0.27% of cases.
Which of the following enteral feeding schedules should be recommended to patients and their families
when preparing for home enteral nutrition?
1: Continue the same schedule as the patient had in hospital
2: Schedule feedings during meal times
3: A schedule that allows for integration of feeding into the patient's and family's lifestyle
4: Feeding schedule that separates the patient during meal time to minimize the family's discomfort with
the process correct answersIn the home, enteral feeding should be integrated into the patient's and
family's typical way of living. Separation of the patient from the family during meal times may have a
negative impact on the family structure, although the administration of tube feeding may not be
accepted by some at the dinner table. A compromise may be necessary to meet all the family members'
needs. Participation in conversations and socialization at the dinner table is encouraged. When possible
in the home setting, the administration schedule should be structured to simulate normal meal times.
Evidence demonstrates that patients and their caregivers quickly adapt the prescribed enteral feeding
regimen to suit themselves and their home circumstances.
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