Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?

Collect fingerstick glucose levels

Implement bleeding precautions

Obtain daily weights

Check urine for albumin

Answer and Explanation

The Correct Answer is A

a) Collect fingerstick glucose levels. Correct

Collecting fingerstick glucose levels is the most important intervention for the PN to implement for a client who is receiving TPN. TPN is a method of feeding that bypasses the gastrointestinal tract and provides all the nutritional needs of the body through a vein. TPN contains a high concentration of glucose, which can cause hyperglycemia or ﬂuctuations in blood sugar levels. Therefore, it is essential to monitor the client's glucose levels frequently and adjust the infusion rate or insulin administration accordingly.

b) Implement bleeding precautions.

Implementing bleeding precautions is not the most important intervention for the PN to implement for a client who is receiving TPN. Bleeding precautions are measures to prevent or minimize bleeding in clients who have a high risk of hemorrhage due to conditions such as thrombocytopenia, coagulopathy, or anticoagulant therapy. TPN does not directly increase the risk of bleeding, although it may aﬀect the liver function and clotting factors in some cases². Therefore, bleeding precautions are not a priority for a client who is receiving TPN.

c) Obtain daily weights.

Obtaining daily weights is not the most important intervention for the PN to implement for a client who is receiving TPN. Obtaining daily weights is a way to monitor the client's ﬂuid balance, nutritional status, and response to therapy. TPN can cause ﬂuid overload, dehydration, or electrolyte imbalances in some cases²⁵. Therefore, obtaining daily weights is important, but not as important as monitoring glucose levels.

d) Check urine for albumin.

Checking urine for albumin is not the most important intervention for the PN to implement for a client who is receiving TPN. Checking urine for albumin is a way to detect proteinuria, which is an indicator of kidney damage or disease. TPN does not directly cause kidney problems, although it may aﬀect the renal function and urine output in some cases². Therefore, checking urine for albumin is not a priority for a client who is receiving TPN.

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Correct Answer is D

Explanation

Acne is a common skin condition that often requires specialized treatment. While general skincare practices can help maintain healthy skin, the most appropriate recommendation for a 16-year-old client seeking treatment for acne is to refer them to a dermatologist.

Acne can have various underlying causes, and eﬀective treatment often involves a tailored approach based on the individual's specific condition. Dermatologists are medical professionals specializing in skin health and are best equipped to assess and provide appropriate treatment options for acne.

Let's brieﬂy evaluate the other options:

a) Wash the hair and skin daily with mild soap and warm water.
While maintaining good hygiene is important for overall skin health, washing the hair and skin alone may not be sufficient to address acne. Acne is a multifactorial condition that requires more comprehensive treatment beyond basic hygiene practices.

b) Omit chocolate, carbonated drinks, and fried foods from the diet.
While diet can play a role in overall skin health, there is limited scientific evidence linking specific foods to the development or worsening of acne. Restricting specific foods may not be the most eﬀective or necessary approach for treating acne. Additionally, dietary changes alone may not address the underlying causes of acne.

c) Express blackheads and follow with an exfoliating scrub.
Squeezing or expressing blackheads can potentially worsen acne and lead to skin damage or infection. It is generally not recommended to atempt self-extraction of blackheads or use aggressive exfoliating scrubs without professional guidance.

In summary, when a 16-year-old client seeks advice for acne, the most appropriate recommendation for the practical nurse (PN) is to refer the client to a dermatologist for prescribed long-term therapy.
Dermatologists have the expertise to evaluate the individual's specific condition and provide appropriate treatment options tailored to their needs.

A. A negative-pressure isolation room B. A positive-pressure isolation room C. A private room D. A semi-private room with a client who has pediculosis capitis

Correct Answer is C

Explanation

Choice A reason: A negative-pressure isolation room is not appropriate for this client because it is used for clients who have airborne infections that can spread through small droplets that remain suspended in the air, such as tuberculosis, measles, or chickenpox. Scabies is a skin infection that is spread by direct contact with infested skin or clothinG.

Choice B reason: A positive-pressure isolation room is not appropriate for this client because it is used for clients who have compromised immune systems and need protection from environmental contaminants, such as bone marrow transplant recipients, burn victims, or organ transplant recipients. Scabies is not caused by environmental contaminants, but by parasitic mites that burrow under the skin.

Choice C reason: A private room is appropriate for this client because it prevents contact transmission of scabies to other clients or stafF. The client should also have dedicated equipment and linens, and wear gloves and gown when leaving the room. The room should be thoroughly cleaned and disinfected after the client's dischargE.

Choice D reason: A semi-private room with a client who has pediculosis capitis is not appropriate for this client because it increases the risk of cross-contamination between the two clients. Pediculosis capitis is a head lice infestation that can also be spread by direct contact with infested hair or personal items.

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Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 16-year-old client is asking the practical nurse (PN) what can be done about acne. Which recommendation should the PN provide?

Correct Answer is D

Explanation

A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?

Correct Answer is C

Explanation

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