TPN Questions

Nurse Spencer is caring for an anorexic client who is having total parenteral nutrition solution for the first time. Which of the following assessments requires the most immediate attention? 1. Dry sticky mouth. 2. Temperature of 100° Fahrenheit. 3. Blood glucose of 210 mg/dl. 4. Fasting blood sugar of 98 mg/dl

3.

A client is being weaned off from parenteral nutrition (PN) and is given a go-signal to take a regular diet. The ongoing solution rate has been 120ml/hr. A nurse expects that which of the following prescriptions regarding the PN solution will accompany the diet order? 1. Decrease the PN rate to 60ml/hr. 2. Start 0.9% normal saline at 30 ml/hr. 3. Maintain the present infusion rate. 4. Discontinue the PN.

1.

A nurse is preparing to hang a fat emulsion (lipids) and observes some visible fat globules at the top of the solution. The nurse ensure to do which of the following actions? 1. Take another bottle of solution. 2. Runs the bottle solution under a warm water. 3. Rolls the bottle solution gently. 4. Shake the bottle solution vigorously.

1.

A nurse is caring for a group of clients on a medical-surgical nursing unit. The nurse recognizes that which of the following clients would be the least likely candidate for parenteral nutrition? 1. A 55-year-old with persistent nausea and vomiting from chemotherapy. 2. A 44-year old client with ulcerative colitis. 3. A 59-year old client who had an appendectomy. 4. A 25-year old client with a Hirschprung's Disease.

3.

A client is receiving parenteral nutrition (PN) in the home setting has a weight gain of 5 lb in 1 week. The nurse next assesses the client to identify the presence of which of the following? 1. Hypotension. 2. Crackles upon auscultation of the lungs. 3. Thirst. 4. Polyuria.

2.

A client receiving parenteral nutrition (PN) complains of a headache. A nurse notes that the client has an increased blood pressure, bounding pulse, jugular distension, and crackles bilaterally. The nurse determines that the client is experiencing which complication of PN therapy? 1. Air embolism. 2. Hypervolemia. 3. Hyperglycemia. 4. Sepsis.

2.

A client is receiving nutrition via parenteral nutrition (PN). A nurse assess the client for complications of the therapy and assesses the client for which of the following signs of hyperglycemia? 1. High-grade fever, chills, and decreased urination. 2. Fatigue, increased sweating, and heat intolerance. 3. Coarse dry hair, weakness, and fatigue. 4. Thirst, blurred vision, and diuresis.

4.

A client receiving parenteral nutrition (PN) complains of shortness of breath and shoulder pain. A nurse notes that the client has an increased pulse rate. The nurse determines that the client is experiencing which complication of PN therapy? 1. Air embolism. 2. Hypervolemia. 3. Hyperglycemia. 4. Pneumothorax

4.

A nurse is caring for a combative client who is ordered to have a nutritional therapy using parenteral nutrition (PN). The nurse should plan which of the following measures to prevent the client from injury? 1. Monitor blood glucose twice a day. 2. Instruct the relative to stay with the nurse. 3. Measure 24-hour intake and output. 4. Secure all connections in the parenteral system

4.

A patient receiving parenteral nutrition is administered via the following routes except: 1. Subclavian line. 2. Central Venous Catheter. 3. PICC (Peripherally inserted central catheter) line. 4. PEG tube.

4.

A nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The client's central venous line is located in the right subclavian vein. The nurse ask the client to take which essential action during the tube change? 1. Turn the head to the right. 2. Inhale deeply, hold it, and bear down. 3. Breathe normally. 4. Exhale slowly and evenly.

2.

A nurse is preparing to hang the initial bag of the parenteral nutrition (PN) solution via the central line of a malnourished client. The nurse ensure the availability of which medical equipment before hanging the solution? 1. Glucometer. 2. Dressing tray. 3. Nebulizer. 4. Infusion pump

4.

A nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that the catheter insertion site appears reddened. The nurse next assesses which of the following items? 1. Time of last dressing change. 2. Tightness of the tuning connections. 3. Client's temperature. 4. Expiration date on the bag

3.

Nurse Russell is preparing to give a total parenteral nutrition using a central line. Place the following steps for administration in the correct order? 1. Connect the tubing to the central line. 2. Regulate the electric infusion pump at the ordered rate. 3. Maintain aseptic technique when handling the injection cap. 4. Check the solution for cloudiness, particles, or a change in color. 5. Prime the IV tubing through an infusion pump. 6. Select and flush the correct tubing and filter. 1. 4, 3, 5, 6, 1, and 2. 2. 6, 4, 5, 1, 3, and 2. 3. 4, 6, 5, 3, 1, and 2. 4. 3, 4, 6, 1, 5, and 2.

3.

A nurse is caring a client who disconnected the tubing of the parenteral nutrition from the central line catheter. A nurse suspects an occurrence of an air embolism. Which of the following is an appropriate position for the client in this kind of situation? 1. On the right side, with head higher than the feet. 2. On the right side, with head lower than the feet. 3. On the left side, with the head higher than the feet. 4. On the left side, with head lower than the feet.

4.

A nurse is conducting a follow-up home visit to a client who has been discharged with a parenteral nutrition(PN). Which of the following should the nurse most closely monitor in this kind of therapy? 1. Blood pressure and temperature. 2. Blood pressure and pulse rate. 3. Height and weight. 4. Temperature and weight.

4.

A nurse observes the client receiving fat emulsions is having hives. A nurse reviews the client's history and note in which of the following may cause about by the complaint of the client? 1. Allergy to an egg. 2. Allergy to peanut. 3. Allergy to shellfish. 4. Allergy to corn.

1.

A client is receiving parenteral nutrition (PN) suddenly is having a fever. A nurse notifies the physician and the physician initially prescribes that the solution and tubing be changed. The nurse should do which of the following with the discontinued materials? 1. Send them to the laboratory for culture. 2. Save them for a return to the manufacturer. 3. Return them to the hospital pharmacy. 4. Discard them in the unit trash.

1.

A nurse is making initial rounds at the beginning of the shift and notice that the parenteral nutrition (PN) bag of an assigned client is empty. Which of the following solutions readily available on the nursing unit should the nurse hang until another PN solution is mixed and delivered to the nursing unit? 1. 10% dextrose in water. 2. 5% dextrose in water. 3. 5% dextrose in normal saline. 4. 5% dextrose in lactated Ringer solution.

1.

A nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notes that the infusion is 2 hours delay. The nurse should do which of the following actions? 1. Adjust the infusion rate to catch up over the next hour. 2. Make sure the infusion rate is infusing at the ordered rate. 3. Increase the infusion rate to catch up over the next few hours. 4. Adjust the infusion rate to full blast until the solution is back on time.

2.