A charge nurse is teaching a newly licensed nurse about the administration of total parenteral nutrition. Which of the following statements should the charge nurse include?

"You will need to change the IV dressing site once per week."

"You will need to warm the solution in the microwave before administration."

"You will need to weigh the client twice per week."

"You will need to monitor the client's electrolytes daily."

Answer and Explanation

The Correct Answer is D

Rationale:

A. "You will need to change the IV dressing site once per week.": Central line dressings for TPN are typically changed every 48–72 hours for gauze or every 5–7 days for transparent dressings, or sooner if the dressing becomes damp, loose, or soiled, to reduce infection risk.

B. "You will need to warm the solution in the microwave before administration.": TPN solutions should never be microwaved due to the risk of uneven heating and nutrient degradation. They should be administered at room temperature.

C. "You will need to weigh the client twice per week.": Clients receiving TPN require daily weights to monitor fluid balance, nutritional status, and detect fluid retention or dehydration promptly. Twice-weekly measurements are insufficient for close monitoring.

D. "You will need to monitor the client's electrolytes daily.": TPN can cause rapid changes in fluid and electrolyte balance, so daily electrolyte monitoring allows timely adjustments to prevent complications such as hypo- or hypernatremia, hypokalemia, and metabolic imbalances.

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Correct Answer is A

Explanation

Rationale:

A. Increased creatinine: Chronic kidney disease reduces the kidneys’ ability to filter waste products effectively, causing creatinine to accumulate in the blood. Elevated creatinine is a key indicator of declining renal function and is expected in this condition.

B. Increased calcium: Clients with chronic kidney disease often have decreased calcium levels due to impaired vitamin D activation and phosphate retention. Increased calcium would be unusual unless the client is receiving supplementation.

C. Increased bicarbonate: Metabolic acidosis is common in chronic kidney disease because the kidneys cannot adequately excrete hydrogen ions or reabsorb bicarbonate. This typically results in decreased, not increased, bicarbonate levels in the blood.

D. Increased hemoglobin: Anemia frequently occurs in chronic kidney disease due to reduced erythropoietin production by the kidneys. This leads to lower hemoglobin levels, so an increase would not be expected unless treated with erythropoiesis-stimulating agents.

A. Expected outcome of the procedure B. Potential complications C. Cost of the procedure D. Explanation of the procedure E. Possible alternative treatments

Correct Answer is ["A","B","D","E"]

Explanation

A. Expected outcome of the procedure: The provider must explain the anticipated results of the colon resection so the client can make an informed decision about proceeding with the surgery.

B. Potential complications: The client should be informed of the risks and possible adverse events associated with the procedure, which is essential for informed consent.

C. Cost of the procedure: Financial information is not required for informed consent. While helpful for planning, it is not part of the medical disclosure required by the provider.

D. Explanation of the procedure: A clear description of the surgical steps allows the client to understand what the procedure entails, which is a fundamental component of informed consent.

E. Possible alternative treatments: The client must be aware of other treatment options, including the choice of no treatment, to make an informed decision regarding surgery.

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A charge nurse is teaching a newly licensed nurse about the administration of total parenteral nutrition. Which of the following statements should the charge nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory data from a client who has chronic kidney disease. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is preparing to witness a client's signature on a consent form for a colon resection. The nurse should recognize that which of the follow information should be provided to the client by the provider before signing the form? (Select all that apply.)

Correct Answer is ["A","B","D","E"]

Explanation

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