A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?

59% dextrose in lactated Ringer's solution (DLR)

0.45% sodium chloride (0.45% NaCl)

10% dextrose in water (DW)

Lactated Ringer's solution

Answer and Explanation

The Correct Answer is C

Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.

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Correct Answer is A

Explanation

Rationale:
A. Hypertonic solutions, like TPN with 25% dextrose, can irritate peripheral veins and cause phlebitis. Administering them through a central line allows rapid dilution in a large volume of blood, reducing vein irritation and promoting safe infusion.
B. Blood glucose monitoring is not dependent on the line type; it is done via peripheral blood samples.
C. The infusion rate is determined by the prescribed therapy, not by whether a central line is used.
D. Central lines do not decrease the risk of infection; in fact, they carry a higher risk of central line–associated bloodstream infections compared with peripheral lines.

A. Family history B. Smoking history C. Alcohol use D. Adalimumab use E. NSAID use F. Positive for Helicobacter pylori

Correct Answer is ["B","E","F"]

Explanation

Rationale:
A. Family history increases risk for heart disease and arthritis but is not a direct risk factor for peptic ulcer disease.
B. Smoking increases gastric acid secretion, reduces mucosal healing, and significantly raises PUD risk.
C. Alcohol use is denied by the client and therefore is not a contributing factor in this case.
D. Adalimumab use (an immunosuppressant for rheumatoid arthritis/psoriasis) does not directly increase PUD risk.
E. NSAIDs inhibit prostaglandin synthesis, reducing the gastric mucosal barrier and predisposing to ulcer formation.
F. H. pylori infection is a primary cause of peptic ulcers due to its damaging effect on gastric mucosa.

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Naxlex Comprehensive Predictor Exams

A student asks the nurse why a peripherally inserted central catheter is needed for a patient receiving parenteral nutrition with 25% dextrose. Which response by the nurse is accurate?

Correct Answer is A

Explanation

A nurse in a provider's office is caring for a client. Exhibits Select the 3 findings from the client's medical record that increase their risk for peptic ulcer disease (PUD).

Correct Answer is ["B","E","F"]

Explanation

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A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

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