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 B

Explanation

Choice A reason: Fluconazole (Diflucan) is not a medication that community members exposed to anthrax will need access to because it is an antifungal drug that treats fungal infections, not bacterial infections. Anthrax is caused by Bacillus anthracis, a gram-positive spore-forming bacterium.

Choice B reason: Ciprofloxacin (Cipro) is a medication that community members exposed to anthrax will need access to because it is an antibiotic drug that treats bacterial infections, including anthrax. Ciprofloxacin is one of the recommended drugs for post-exposure prophylaxis and treatment of anthrax by the Centers for Disease Control and Prevention (CDC).

Choice C reason: Varenicline (Chantix) is not a medication that community members exposed to anthrax will need access to because it is a smoking cessation drug that helps people quit smoking, not treat infections. Varenicline has no effect on anthrax.

Choice D reason: Potassium iodide (KI) is not a medication that community members exposed to anthrax will need access to because it is a thyroid-blocking agent that protects against radioactive iodine exposure, not bacterial exposurE. Potassium iodide is used in case of nuclear accidents or attacks, not bioterrorism attacks involving anthrax.

A. Heart sounds B. Chest pain C. Bilateral lung sounds D. Mood and aﬀect

Correct Answer is C

Explanation

c) Bilateral lung sounds.

Explanation:

When admitting a client with complications of left-sided heart failure, the practical nurse (PN) should prioritize assessing the client's bilateral lung sounds. Left-sided heart failure can result in the accumulation of ﬂuid in the lungs, leading to pulmonary congestion and impaired gas exchange. By auscultating the client's lung sounds, the PN can assess for the presence of crackles, wheezes, or diminished breath sounds, which are indicative of pulmonary congestion and ﬂuid accumulation. This assessment helps to identify the severity of the client's condition and guides further interventions and treatment.

While assessing heart sounds (option a) is important in evaluating cardiac function, assessing lung sounds takes priority as pulmonary congestion is a common manifestation of left-sided heart failure. Chest pain (option b) is a significant symptom that should be assessed promptly, but in this scenario, the focus is on assessing for signs of pulmonary congestion and impaired gas exchange. Assessing the client's mood and aﬀect (option d) is important for a comprehensive assessment, but it is not the priority when the client is admited with complications of left-sided heart failure.

The other options are considered incorrect because they are not the priority assessments when admitting a client with complications of left-sided heart failure.

Option a) Heart sounds: While assessing heart sounds is important in evaluating cardiac function, the priority in this scenario is to assess for pulmonary congestion and impaired gas exchange. Assessing bilateral lung sounds allows the practical nurse to gather immediate information about the client's respiratory status and the presence of ﬂuid in the lungs.

Option b) Chest pain: Chest pain is a significant symptom that should be assessed promptly, as it could indicate various cardiac or respiratory conditions. However, in this specific scenario, the priority is to assess for signs of pulmonary congestion, which can have a more immediate impact on the client's respiratory function.

Option d) Mood and aﬀect: Assessing the client's mood and aﬀect is important for a comprehensive assessment of their emotional well-being. However, when admitting a client with complications of left- sided heart failure, the priority is to assess their physical condition, particularly the respiratory status, to address any immediate concerns related to pulmonary congestion and impaired gas exchange.

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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

The community health nurse is making a list of needed supplies in the event of a bioterrorism attack. The nurse recognizes that community members exposed to anthrax will need access to which of the following medications?

Correct Answer is B

Explanation

The practical nurse (PN) is assisting with the admission of a client with complications of left-sided heart failure. Which focused assessment should the PN implement first?

Correct Answer is C

Explanation

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