The nurse is preparing to hang the client's next bag of Total Parenteral Nutrition (TPN) and observes fat globules rising to the top of the solution. What action should the nurse take?

Run the bag under warm water to melt the globules.

Call the pharmacy to get a new bag of TPN.

Do nothing, as fat globules are expected to rise to the top of the TPN solution.

Roll the bag of solution gently to redistribute the fat.

Answer and Explanation

The Correct Answer is B

Choice A Reason
Running the bag under warm water to melt the globules is not recommended. Applying heat could compromise the sterility and integrity of the solution. TPN solutions are carefully balanced and sterile, and any manipulation involving temperature changes could lead to contamination or nutrient degradation.

Choice B Reason
Observing fat globules at the top of the TPN solution is a sign that the emulsion may be compromised. The nurse should not administer this TPN solution and should call the pharmacy for a replacement. TPN solutions should be homogenous with no visible separation or fat globules to ensure the patient receives the correct nutrition and to prevent complications.

Choice C Reason
Doing nothing is not an appropriate action. Fat globules indicate that the solution has separated, which can lead to an unstable emulsion and potential harm if infused. The nurse's responsibility is to ensure the safety and efficacy of the treatment, which includes verifying that TPN solutions are properly mixed.

Choice D Reason
Rolling the bag gently to redistribute the fat is not a safe practice. While gentle agitation can be used for some medications, it is not appropriate for TPN solutions with visible fat globules. This could further destabilize the emulsion and does not address the underlying issue of separation.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A Reason
Metoprolol, a beta-blocker, can cause fluid retention, which may lead to swelling in the ankles. However, this is not a common side effect and is not typically included as a standard warning for patients starting on metoprolol. Patients should be aware of this potential side effect but also understand that it may not occur.

Choice B Reason
Patients should not stop taking metoprolol abruptly, especially if they experience fatigue, which can be a common side effect. Abrupt cessation can lead to rebound hypertension or angina. Instead, patients should consult their healthcare provider if they experience significant fatigue that impacts their daily activities.

Choice C Reason
Checking the pulse is an important self-monitoring measure for patients on metoprolol. This medication can slow the heart rate, and patients should be instructed on how to check their pulse and what to do if it falls below a certain rate, as advised by their healthcare provider.

Choice D Reason
While staying hydrated is generally good advice, there is no specific need to drink plenty of fluids related to the use of metoprolol for angina pectoris. Patients should follow normal hydration guidelines unless otherwise directed by their healthcare provider.

A. Maintain normal salt and fluid intake in the diet. B. Drink twice the usual amount of fluids daily. C. Avoid eating aged cheese, processed meats, and red wine. D. Double the lithium dose if diarrhea or vomiting occurs.

Correct Answer is A

Explanation

Choice A Reason:
Maintaining normal salt and fluid intake is crucial for patients on lithium. Lithium can affect sodium levels in the body, and consistent sodium intake helps to keep lithium levels stable. Patients should be advised to drink adequate fluids to prevent dehydration but avoid excessive fluid intake, which could alter lithium levels and potentially lead to toxicity¹²³⁴.

Choice B Reason:
Drinking twice the usual amount of fluids daily is not recommended for patients on lithium unless directed by a healthcare provider. Excessive fluid intake can lead to changes in lithium levels and increase the risk of lithium toxicity. Patients should aim to consume a sufficient amount of fluids to stay hydrated, especially in situations that may lead to dehydration, such as during hot weather or illness.

Choice C Reason:
Avoiding aged cheese, processed meats, and red wine is generally advised for patients taking monoamine oxidase inhibitors (MAOIs), not lithium. These foods can contain high levels of tyramine, which can interact with MAOIs. However, there are no specific dietary restrictions for lithium regarding these foods. Patients should follow a balanced diet and consult with their healthcare provider for personalized dietary advice.

Choice D Reason:
Doubling the lithium dose if diarrhea or vomiting occurs is incorrect and potentially dangerous. If a patient experiences diarrhea or vomiting, it can affect lithium absorption and increase the risk of toxicity. Instead, patients should contact their healthcare provider for guidance. Adjustments to the medication regimen should only be made under medical supervision.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is preparing to hang the client's next bag of Total Parenteral Nutrition (TPN) and observes fat globules rising to the top of the solution. What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching to a client with angina pectoris who is prescribed metoprolol 50 mg PO daily. Which information should the nurse include in the teaching?

Correct Answer is C

Explanation

The nurse's teaching plan for a client taking lithium should include instructions to:

Correct Answer is A

Explanation

The client has passed a renal calculus that is determined to be composed of calcium oxalate. Which discharge instruction should be given by the nurse?

A nurse is assessing a client newly diagnosed with early-onset osteoarthritis. Which manifestation should the nurse expect?

For a client newly diagnosed with Type 2 diabetes mellitus who has a BMI index of 28, which information should the nurse include in the teaching plan? (Select all that apply)

A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:

A nurse is discussing fibromyalgia with a client who is concerned about developing the disorder. Which finding would the nurse identify as a risk factor for this disease?

Which data is cause for immediate intervention for a client after a right shoulder replacement?

When addressing a local community group on the topic of obesity, the nurse should include the following points:

For a client diagnosed with folic acid deficiency anemia who is experiencing activity intolerance, what should the nurse include in the plan of care?