A nurse is caring for a client who has a prescription for total parental nutrition (TPN).
Which of the following routes of administration should the nurse use?
Subcutaneous
Intraosseous
Midline catheter
Central venous access device
The Correct Answer is D
Choice A rationale: TPN cannot be administered subcutaneously due to its composition.
Choice B rationale: Intraosseous access is for emergency situations when IV access isn't attainable.
Choice C rationale: A midline catheter might not be suitable for the hypertonic nature of TPN and can lead to complications.
Choice D rationale: Total parenteral nutrition (TPN) is a hypertonic solution that requires infusion into a large vein. The central venous access device allows for high-flow rates and avoids irritation or damage to smaller peripheral veins.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: The nurse who caused the error is not responsible for completing an incident report, which is a tool for quality improvement and risk management. The incident report should include the facts of the error, the actions taken, and the outcome of the client.
Choice B rationale: The nurse who identifies the error should notify the nurse who caused the error, the charge nurse, and the provider, but they are and they are responsible for completing the report.
Choice C rationale: The quality improvement committee may review incident reports but is not directly responsible for completing them.
Choice D rationale: The charge nurse may oversee the incident report process but is not primarily responsible for completing it.
Correct Answer is A
Explanation
Choice A rationale: A lithium level of 2.6 mEq/L is significantly elevated and poses a risk of lithium toxicity. Hemodialysis is the most effective intervention to rapidly lower the lithium level in severe cases of toxicity.
Choice B rationale: Left lateral positioning is not the priority in this situation; immediate intervention to lower the lithium level is necessary.
Choice C rationale: Fluid restrictions alone might not rapidly lower the elevated lithium level in severe toxicity.
Choice D rationale: Given the elevated level, increasing the dosage would exacerbate toxicity and is inappropriate.
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