A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

Change the TPN tubing every 48 hr

Allow 18 hr for the lipids to infuse when not mixed with the TPN solution.

Use a 1.2 micron filter when infusing TPN with fat emulsions added.

Change the TPN solution after 36 hr.

Answer and Explanation

The Correct Answer is C

Rationale:

A. The tubing for TPN must be changed every 24 hr (not 48 hr) to reduce the risk of central line–associated bloodstream infection (CLABSI).

B. Lipid emulsions should not hang for more than 12 hr to prevent bacterial growth and infection.

C. A 1.2-micron filter is required for TPN that contains lipids to remove particulate matter, bacteria, and fungi, since lipid solutions cannot pass through smaller filters.

D. TPN solutions should be changed every 24 hr (not 36 hr) to reduce infection risk.

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Correct Answer is B

Explanation

Rationale:
A. Epigastrium refers to the upper central region of the abdomen, just below the sternum; Cullen’s sign does not appear here.
B. Umbilical region (around the navel) is where Cullen’s sign appears as a bluish discoloration due to subcutaneous fat necrosis or retroperitoneal bleeding associated with acute pancreatitis. This is the correct site.
C. Flank discoloration is known as Grey Turner’s sign, another indicator of retroperitoneal bleeding, but distinct from Cullen’s sign.
D. Subumbilical refers to the area below the umbilicus, not the typical site for Cullen’s sign.

A. Disinfect equipment in the client's room daily. B. Use alcohol hand sanitizer after completing tasks for the client. C. Place the client in a protective environment. D. Have the client wear a mask when out of the room.

Correct Answer is A

Explanation

Rationale:
A. Clostridium difficile spores are resistant to alcohol and can persist on surfaces. Daily disinfection with a sporicidal agent is essential to prevent transmission.

B. Alcohol-based hand sanitizers are ineffective against C. difficile spores. Handwashing with soap and water is required after contact with the client or contaminated surfaces.

C. A protective environment is used for immunocompromised clients, not for those with C. difficile.

D. Masks are not necessary for routine C. difficile care because the bacteria are spread via the fecal-oral route, not airborne.

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A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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