A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.
Which of the following instructions should the nurse include? (Select all that apply.)

Infuse 10 percent dextrose and water if the solution runs out.

Shake the TPN bag with fat emulsion if precipitate is present.

Maintain TPN infusion rate when behind schedule.

Keep the TPN refrigerated when not in use.

Answer and Explanation

Correct Answer : A,D

Choice A rationale

Infusing 10 percent dextrose and water prevents hypoglycemia if TPN is temporarily unavailable. This is a crucial step in maintaining the patient's blood sugar levels.

Choice B rationale

Shaking the TPN bag with fat emulsion can cause the emulsion to break, leading to potential complications. Fat emulsions should be mixed gently.

Choice C rationale

Maintaining the TPN infusion rate when behind schedule is incorrect as it can lead to rapid infusion and complications such as hyperglycemia and fluid overload.

Choice D rationale

Keeping the TPN refrigerated when not in use helps to maintain its stability and prevent bacterial contamination. Proper storage is essential for patient safety. .

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Correct Answer is C

Explanation

Choice A rationale

Administering insulin when the breakfast tray arrives may not provide sufficient time for the insulin to take effect before the client begins eating, potentially leading to hyperglycemia.

Choice B rationale

Administering insulin at 07: is too early and may result in hypoglycemia before the client eats breakfast.

Choice C rationale

Administering insulin at 07: allows sufficient time for the insulin to take effect before the client eats breakfast, helping to maintain appropriate blood glucose levels.

Choice D rationale

Administering insulin 30 minutes after breakfast is too late and could result in hyperglycemia since the client would have already consumed carbohydrates.

A. A. Serum creatinine. B. Urine for microalbuminuria. C. Hearing (audio) exam. D. Chest x-ray. E. Monofilament testing of the foot.

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

Explanation

Choice A rationale

Serum creatinine is assessed annually to evaluate kidney function, as diabetes can lead to nephropathy and renal impairment.

Choice B rationale

Urine for microalbuminuria is important to detect early kidney damage, which can occur in diabetic nephropathy.

Choice C rationale

Hearing (audio) exam is not a standard annual test for diabetic complications. Diabetes primarily affects the vascular system, kidneys, and nerves.

Choice D rationale

Chest x-ray is not routinely performed annually for diabetes management. It is used when there are specific indications such as respiratory symptoms.

Choice E rationale

Monofilament testing of the foot is conducted annually to detect diabetic neuropathy and prevent foot ulcers and infections.

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A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.Which of the following instructions should the nurse include? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 08:00 am. After checking the client's morning glucose level, which of the following actions should the nurse take?

Correct Answer is C

Explanation

To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually? Select all that apply.

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

Explanation

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A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.
Which of the following instructions should the nurse include? (Select all that apply.)