A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?
Uses the TPN IV tubing to administer the client's next dose of antibiotics
Plans for a check of the client's fingerstick glucose level every 6 hr
Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved
Schedules a bag and tubing change for 24 hr after the start of the infusion
The Correct Answer is A
Rationale:
A. Uses the TPN IV tubing to administer the client's next dose of antibiotics: TPN lines should never be used for administering other medications or fluids because this increases the risk of contamination, infection, and incompatibility reactions. TPN requires dedicated IV access to maintain sterility and prevent complications such as sepsis.
B. Plans for a check of the client's fingerstick glucose level every 6 hr: Monitoring blood glucose regularly is essential during TPN administration because high dextrose concentrations can cause hyperglycemia. Checking every 4–6 hours aligns with safe monitoring practices and does not require intervention.
C. Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved: Slowly titrating the TPN rate helps the client adjust to the high glucose content and reduces the risk of hyperglycemia or fluid overload. This demonstrates safe and appropriate administration practice.
D. Schedules a bag and tubing change for 24 hr after the start of the infusion: Changing the TPN solution and tubing every 24 hours is consistent with infection control guidelines. This action maintains sterility and prevents microbial growth, reflecting proper technique.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Boiled eggs: While eggs contain some iron, the type is nonheme, and their consumption alone does not significantly enhance absorption. Eggs lack the vitamin C necessary to improve nonheme iron absorption from plant-based foods.
B. Cheddar cheese: Cheese contains minimal iron and is low in vitamin C. It does not aid in the absorption of nonheme iron and may actually inhibit iron absorption when consumed with iron-rich plant foods due to its high calcium content.
C. Mixed nuts: Nuts provide some nonheme iron, but they do not contain vitamin C to enhance absorption. Consuming nuts alone will not improve bioavailability of iron in a vegetarian diet.
D. Orange slices: Vitamin C in oranges significantly enhances the absorption of nonheme iron from plant-based foods by converting it into a more absorbable form. Including vitamin C-rich foods like oranges with meals helps increase iron uptake, which is particularly important for clients following vegetarian diets.
Correct Answer is D
Explanation
Rationale:
A. “Our children can stay up as late as they prefer.” This statement reflects a permissive parenting style, where few rules are enforced and children have significant freedom. Parents in this style often avoid setting firm boundaries, which contrasts sharply with the strict control seen in authoritarian parenting.
B. “Our children are allowed to make their own choices.” This reflects an authoritative parenting style, which balances independence with guidance. Authoritative parents encourage decision-making while still providing consistent rules and support. This collaborative, approach differs significantly from the rigid and demanding nature of authoritarian parenting.
C. “We make decisions as a family.” This statement also aligns with authoritative parenting, which values communication, mutual respect, and shared problem-solving. Children’s input is considered, helping them develop confidence and reasoning skills. Such family-centered decision-making is not present in authoritarian households.
D. “We expect our children to do what we say without any questions.” Authoritarian parenting focuses on obedience, strict rules, and limited negotiation. Children are expected to comply without explanation, and parents often enforce discipline rigidly. This style places emphasis on control rather than communication.
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