A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

serum white blood cell count of 16,000/mm3.

pre-albumin level less than 10 mg/dl

maintenance of baseline weight or gain of up to 1 kg/day.

negative nitrogen balance.

Answer and Explanation

The Correct Answer is C

C. The expected effect of TPN is to maintain or promote weight gain in clients who are unable to meet their nutritional needs orally. TPN provides essential nutrients directly into the bloodstream, allowing for adequate caloric intake to support energy needs and promote tissue repair and growth.
A. A serum white blood cell count of 16,000/mm3 indicates leukocytosis, which may suggest infection or inflammation rather than a direct effect of TPN.
B. Pre-albumin is a marker of nutritional status, and levels below 10 mg/dl typically indicate malnutrition rather than a positive response to TPN.
D. Negative nitrogen balance occurs when the body loses more nitrogen than it gains, typically due to inadequate protein intake or increased protein breakdown. TPN provides amino acids, which are the building blocks of protein, and aims to promote a positive nitrogen balance to support tissue repair and growth.

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Correct Answer is B

Explanation

A. While it may have some impact on kidney function indirectly through its effects on blood pressure and heart function, urine output is not the primary parameter used to assess the effectiveness of carvedilol in a patient with a history of unstable angina.
B. Carvedilol, as a beta-blocker, helps reduce heart rate by blocking the effects of adrenaline on the heart. In unstable angina, lowering the heart rate can reduce myocardial oxygen demand, which is beneficial in managing ischemic symptoms
C. Carvedilol primarily affects heart rate and blood pressure but doesn't directly regulate heart rhythm. However, in patients with certain cardiac conditions, like heart failure or left ventricular dysfunction after a heart attack, carvedilol can sometimes help to stabilize heart rhythm indirectly by reducing stress on the heart.
D. Carvedilol is also effective in reducing blood pressure, which is beneficial in patients with unstable angina, as it decreases the workload on the heart and the oxygen demand of the myocardium. A blood pressure reading of 120/90 is within the normal range for an adult and indicates good control of blood pressure.

A. "How are you managing stressful situations?" B. "Have you made an appointment for your annual colonoscopy?" C. "Are you taking your medications regularly?" D. "Are you getting enough rest?"

Correct Answer is C

Explanation

C. Medication adherence is vital for controlling inflammation and preventing flare-ups in ulcerative colitis. Therefore, ensuring that the client is taking their medications as prescribed is a primary focus of disease management, regardless of how well they have learned to manage the condition.
A. Stress can exacerbate symptoms of ulcerative colitis and may contribute to flare-ups. Therefore, understanding how the client manages stress is important. However, given that the client has lived with ulcerative colitis for close to 15 years and has learned to manage it well, this question may be less of a primary focus compared to other aspects of disease management.
B. Regular monitoring through colonoscopy is essential for detecting any changes or complications associated with ulcerative colitis, such as inflammation, dysplasia, or colon cancer.
D. While rest and adequate sleep are important for overall health and well-being, they may not be as directly related to ulcerative colitis management as medication adherence, monitoring, and stress management.

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A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

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Naxlex Comprehensive Predictor Exams

The nurse is evaluating the medical prescription of carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication's action has been effective?

Correct Answer is B

Explanation

The client has lived with ulcerative colitis for close to 15 years and has learned to manage it very well. At this point in time, the nurse's discussion with the client about this disease should have a primary focus on which question?

Correct Answer is C

Explanation

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