Question 1

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

In situations where partial or complete intestinal failure has occurred and oral nutrition or enteral tube feeding is not possible,parenteral nutrition (PN)is the therapy of choice.When a patient's gastrointestinal (GI)tract is functional,clinicians assess the patient and choose the best method of delivering nutritional needs,which may include enteral feeding,parenteral feeding,or a combination of both.

Question 2

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 3

The patient will be discharged to home on parenteral nutrition (PN).The patient and his family education 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

The patient and family caregiver will need to learn to monitor the patient's weight,blood glucose levels,and intake and output.They will also need to know how to perform catheter care and dressing changes.Home-based parenteral nutrition (PN)can be managed to allow the patient a reasonable amount of mobility and limiting activity should not be required.

Question 4

To detect a common untoward 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

Do not interrupt a parenteral nutrition (PN)infusion.This infusion maintains a continuous supply of nutrients and prevents a hypoglycemic reaction.Fever could be caused by systemic infection.Chest pain could be caused by air embolism.Localized infection can occur at the exit site or tunnel.

Question 5

If parenteral nutrition (PN)must be discontinued suddenly,hang __________ in water at the same infusion rate to prevent hypoglycemia.

Accepted Answer

The answer of If parenteral nutrition (PN)must be discontinued suddenly,hang...

Question 6

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 7

The patient has been ordered to receive 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

The ideal method to administer parenteral nutrition (PN)over an extended period is through a central venous catheter,which allows for higher concentration of nutrients.

Question 8

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

For PN to be used safely,its administration must be closely monitored.Special care is necessary to maintain blood glucose levels in the normal range.Higher glucose levels are often associated with cardiovascular events,general infection,systemic sepsis,acute renal failure,and death.

Question 9

A patient receiving parenteral nutrition (PN)has gained 4 pounds 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

Weight gain greater than 1 pound/day indicates fluid retention.The patient's ideal weight gain is usually between 1 and 2 pounds/week.Weight is an indicator of the patient's nutritional status and determines fluid volume.A nutritional regimen without adequate fatty acids leads to essential fatty acid deficiency (EFAD),characterized by dry,scaly skin,sparse hair growth,impaired wound healing,decreased resistance to stress,increased susceptibility to respiratory tract infection,anemia,thrombocytopenia,and liver function abnormalities.

Question 10

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

Know the patient's recent temperature range.Patients with peripheral or central intravenous (IV)lines are susceptible to septicemia;elevated temperature can be an early indicator of a bacterial process.Hypoglycemia causes the patient to be shaky,dizzy,nervous,and anxious;the patient senses hunger and has a blood sugar level less than 80 mg/100 mL.Air embolism results in sudden respiratory distress,shortness of breath,coughing,chest pain,and decreased blood pressure.Hyperglycemia leads to excessive thirst.

Question 11

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

The answer of During intravenous (IV)administration of fat (lipid)emulsions,the patient...

Question 12

Which assessment should a nurse expect to see for a patient receiving parenteral nutrition (PN)?&#10;A)Weight gain of 1 to 2 pounds per week&#10;B)Serum calcium level of 10 mEq/L&#10;C)Serum potassium level of 2.8 mEq/L&#10;D)Serum glucose level of more than 200 mg/100 mL

Accepted Answer

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

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

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 answer of A patient had surgery 1 week ago,has...

Deck 33: Parenteral Nutrition