A nurse is caring for a client who has been receiving long-term total parenteral nutrition (TPN). Which of the following actions should the nurse take first to taper the client from the TPN?
Encourage the client to take sips of diluted fruit juice.
Give the client a pureed diet.
Check the client's swallowing reflex.
Provide the client with a full liquid diet.
The Correct Answer is C
A. Encourage the client to take sips of diluted fruit juice: Offering small amounts of juice may help introduce oral intake gradually, but it is not the first step. Ensuring the client can safely swallow is essential before providing any oral fluids to prevent aspiration and other complications.
B. Give the client a pureed diet: Transitioning to a pureed diet is part of advancing nutrition after confirming that the client can swallow safely. Starting this too early without assessing swallowing ability can increase the risk of choking or aspiration.
C. Check the client's swallowing reflex: Assessing the swallowing reflex is the priority when tapering a client from TPN. Safe oral intake depends on intact swallowing function, and identifying any deficits early prevents aspiration, aspiration pneumonia, or other serious complications during the transition to oral nutrition.
D. Provide the client with a full liquid diet: A full liquid diet is a step in progressing from TPN to oral intake, but it should only be introduced after confirming the client can swallow safely. Skipping the assessment of the swallowing reflex could place the client at risk for airway compromise.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
A. Heart rate 190/min: A normal newborn heart rate ranges from 120 to 160 beats per minute. A heart rate of 190/min is tachycardic and is above the expected range for a healthy newborn.
B. Irregular respirations: Newborns often exhibit irregular respirations with periods of rapid breathing followed by pauses. This pattern is expected in the first few hours after birth and usually does not indicate distress if oxygen saturation is normal.
C. Central cyanosis: Central cyanosis, including blue lips or tongue, is abnormal and may indicate hypoxemia or congenital heart or respiratory issues. Normal newborns may show brief acrocyanosis of hands and feet but not central cyanosis.
D. Temperature of 38.2° C (100.8° F): A normal newborn temperature ranges from 36.5° C to 37.5° C (97.7° F to 99.5° F). A temperature of 38.2° C is elevated and may indicate infection or overheating.
Correct Answer is B
Explanation
A. "Adolescents should increase their daily sodium intake to more than 2,800 milligrams.": This is incorrect because adolescents should limit sodium intake to less than 2,300 milligrams per day to reduce the risk of hypertension and cardiovascular issues. Excess sodium intake is associated with negative health outcomes rather than benefits.
B. "Adolescents should aim to consume at least 1,300 milligrams of calcium each day.": This is correct because adolescents require adequate calcium to support rapid bone growth and peak bone mass development. Meeting calcium needs during adolescence helps prevent future osteoporosis and supports overall skeletal health.
C. "Adolescent males require more iron than females due to the increase in their muscle mass.": This is incorrect because adolescent females typically require more iron than males due to menstrual blood loss. Iron is essential for hemoglobin production, and females are at higher risk for iron deficiency during adolescence.
D. "Adolescent females should consume 200 micrograms of folic acid every day.": This is inaccurate because the recommended daily allowance (RDA) for folic acid in adolescents is 400 micrograms per day, not 200. Adequate folic acid is critical for DNA synthesis and overall growth during adolescence.
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