Question 1

The nurse is caring for a patient receiving parenteral nutrition (PN).In planning the patient's care for the day,which nursing assessment is most essential?&#10;A) Electrolyte levels&#10;B) Weight&#10;C) Temperature&#10;D) Condition of catheter insertion site

Accepted Answer

Since the need for parenteral nutrition (PN)is usually associated with conditions that result in electrolyte instability,maintaining electrolyte balance during therapy is crucial.Monitor the patient's electrolyte levels (potassium,magnesium,and phosphorus)for low serum levels which may indicate a risk for arrhythmias and muscle weakness,Patients at risk may require having electrolyte panels done several times a day.While it is necessary to monitor the patient's weight and temperature and be alert for signs of infection at the insertion site,the biggest risk to the patient is electrolyte instability.

Question 2

To detect a common but unwanted effect of interrupting a parenteral nutrition (PN)infusion,the nurse should assess the patient for development of which symptom?&#10;A) Fever&#10;B) Chest pain&#10;C) Erythema and induration&#10;D) Shaking and dizziness

Accepted Answer

Interrupting a parenteral nutrition infusion can lead to hypoglycemia, which may cause symptoms such as shaking and dizziness.

Question 3

A 72-year-old patient is admitted to the hospital with a medical diagnosis of intestinal failure.Which intervention should the nurse include in the plan of care to deliver nutritional needs?&#10;A) Enteral nutrition (EN)&#10;B) Parenteral nutrition (PN)&#10;C) A combination of enteral and parenteral nutrition&#10;D) Oral nutrition

Accepted Answer

Intestinal failure refers to the inability of the small intestine to absorb nutrients and fluids adequately. This patient may require parenteral nutrition, which is the delivery of nutrients directly into the bloodstream through a catheter. The older age of the patient may increase their malabsorption, making parenteral nutrition the best option to ensure they receive adequate nutritional support. Enteral nutrition, a combination of enteral and parenteral nutrition, or oral nutrition may not be sufficient in providing the necessary nutritional needs for this patient.

Question 4

The patient will be discharged to home on parenteral nutrition (PN).The patient and his caregiver will need to perform which of the following care steps? (Select all that apply.)&#10;A) Monitor the patient's weight.&#10;B) Monitor the patient's serum glucose levels.&#10;C) Measure the patient's intake and output.&#10;D) Perform catheter care.&#10;E) Limit the patient's activity.

Accepted Answer

Monitoring weight, serum glucose levels, and intake/output are essential to ensure the effectiveness and safety of PN. Catheter care is crucial to prevent infections. Limiting activity is not a standard requirement for PN care.

Question 5

A patient had surgery 1 week ago,has not been eating his meals,and states that he has no appetite.The nurse assesses that the patient has been progressively losing weight.Which intervention has the highest priority?

A) Encourage the patient to eat.
B) Force-feed the patient.
C) Consult with the nutritional support team.
D) Be aware that the patient will come around when hungry.

Accepted Answer

The patient's lack of appetite and weight loss may be indicative of a nutritional deficit that needs to be addressed. Consulting with the nutritional support team can provide a more specialized and comprehensive approach to addressing the patient's nutritional needs, which may include specialized dietary recommendations or the use of nutritional supplements. Forcing or pressuring the patient to eat may be counterproductive and cause further distress or discomfort, while simply encouraging the patient to eat may not fully address the underlying issue. Waiting for the patient to become hungry may also be ineffective and potentially dangerous if the patient's condition worsens due to malnourishment.

Question 6

If parenteral nutrition (PN)must be discontinued suddenly,hang _______ at the same infusion rate to prevent hypoglycemia.&#10;A) normal saline&#10;B) 10% dextrose in water&#10;C) enteral formula&#10;D) sterile water

Accepted Answer

10% dextrose in water is used to prevent hypoglycemia when PN is discontinued suddenly, as it provides a source of glucose.

Question 7

The nurse is caring for a patient who is receiving parenteral nutrition (PN).The nurse realizes that PN is associated with which of the following risks? (Select all that apply.)&#10;A) Decreased mortality&#10;B) Bloodstream infection&#10;C) Pneumothorax&#10;D) Decreased length of stay&#10;E) Liver disease

Accepted Answer

Use of parenteral nutrition (PN)in the perioperative patient is controversial,and although benefits are more likely in the severely malnourished,evidence has shown little effect of PN in preventing mortality.PN creates risks.It has been associated with catheter-related bloodstream infection,noninfective complications such as pneumothorax,increased hospital length of stay,and liver disease.

Question 8

The nurse is managing the care of a patient receiving parenteral nutrition (PN).Which assessment finding indicates potential septicemia?&#10;A) Shakiness and dizziness&#10;B) Chest pain/hypotension&#10;C) Increased thirst&#10;D) Increased temperature

Accepted Answer

An increased temperature may indicate potential septicemia, which is a serious complication of PN. Symptoms of septicemia may also include hypotension, tachycardia, chills, and confusion. Shakiness and dizziness are not typical symptoms of septicemia, and increased thirst is a common side effect of PN. Chest pain may indicate other complications, such as a pulmonary embolism, but is not specific to septicemia.

Question 9

The patient has been prescribed parenteral nutrition (PN)but will require the nutritional therapy to continue for several months.Which route is most important for the nurse to consider?&#10;A) Second intravenous line&#10;B) Enteral feeding tube&#10;C) Central venous access device (CVAD)&#10;D) Parenteral feeding tube

Accepted Answer

For long-term parenteral nutrition, a central venous access device (CVAD) is most appropriate as it allows for the administration of highly concentrated nutrient solutions directly into the bloodstream.

Question 10

During intravenous (IV)administration of fat (lipid)emulsions,the patient voices complaints.Which complaint indicates to the nurse that the patient is experiencing a complication associated with the administration?

A) Fever,chills,and malaise
B) Low temperature,chills,and headache
C) Fever,flushing,and muscle relaxation
D) Low temperature,muscle aches,and dyspnea

Accepted Answer

Fever, chills, and malaise are common signs of an infusion reaction or sepsis, which are potential complications associated with IV administration of lipid emulsions. Low temperature, chills, headache, flushing, muscle relaxation, muscle aches, and dyspnea are not specific to complications related to lipid emulsion administration.

Question 11

A patient receiving parenteral nutrition (PN)has gained 2 kg over a 24-hour period.Given this weight gain,which interpretation by the nurse is most accurate?&#10;A) Increased nutrition from the patient's parenteral infusions&#10;B) Decreased linoleic acid intake&#10;C) Increased fluid loss&#10;D) Fluid retention

Accepted Answer

The answer of A patient receiving parenteral nutrition (PN)has gained...

Question 12

The nurse is caring for a patient who is receiving PN.As part of therapy,the patient undergoes routine bedside glucose monitoring that reveals which expected outcome?&#10;A) Lower than normal blood glucose to determine adequate tolerance for PN&#10;B) Slightly higher than normal blood glucose to meet increased cellular needs&#10;C) Slightly higher than normal blood glucose to prevent infection or systemic sepsis&#10;D) Normal blood glucose to prevent associated complications

Accepted Answer

The answer of The nurse is caring for a patient...

Question 13

The nurse has been caring for a patient who has had a central venous access device (CVAD)in place.The patient complains of sudden chest pain and difficulty breathing.These assessment findings are symptoms of which severe complication?

A) Exit site infection
B) Catheter-related sepsis
C) Pneumothorax
D) Hyperglycemia

Accepted Answer

The answer of The nurse has been caring for a...

Question 14

Which assessment should a nurse expect to see for a patient receiving parenteral nutrition (PN)?&#10;A) Weight gain of 0.5 kg per week&#10;B) Crackles in the lungs&#10;C) Serum potassium level of 2.8 mmol/L&#10;D) Serum glucose level of more than 8.3 mmol/L

Accepted Answer

The answer of Which assessment should a nurse expect to...

Deck 33: Parenteral Nutrition