While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Serum protein.

Serum osmolarity.

Urinary ketones.

Capillary glucose.

Answer and Explanation

The Correct Answer is D

A. Serum protein is an indicator of the client’s overall nutritional status, but it is not as immediately critical to monitor as glucose levels in clients receiving TPN. Protein levels change more slowly over time and are not an acute concern.

B. While serum osmolarity is important in evaluating hydration status and electrolyte balance, it is not the primary lab to monitor during TPN administration. Glucose fluctuations are more likely to cause immediate complications.

C. Urinary ketones are typically monitored in clients with diabetic ketoacidosis (DKA), not in clients receiving TPN. Ketones are a byproduct of fat metabolism and are not a priority in TPN management.

D. Capillary glucose is the most important lab to monitor in clients on TPN because TPN solutions contain high amounts of glucose, which can lead to hyperglycemia. Monitoring glucose levels helps prevent complications such as hyperglycemia or hypoglycemia and is critical in managing the client's metabolic response to TPN.

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Correct Answer is D

Explanation

Choice A: A complete blood count (CBC) is important for monitoring various aspects of the blood, including the number of red blood cells, white blood cells, and platelets. While important for assessing overall health, a CBC is not the primary laboratory finding used to assess the effectiveness of warfarin in managing atrial fibrillation.

Choice B: Serum troponin levels are typically measured to assess cardiac muscle damage, such as in myocardial infarction (heart attack). They are not the primary indicator for assessing the effectiveness of warfarin in atrial fibrillation.

Choice C: Creatinine clearance is a measure of kidney function and is not the primary laboratory finding used to evaluate the effectiveness of warfarin.

Choice D: Prothrombin time (PT) is the most relevant laboratory finding for monitoring the effectiveness of warfarin in clients with atrial fibrillation. Warfarin's therapeutic effect is primarily assessed through PT measurements, with the goal of maintaining the client's international normalized ratio (INR) within a specific target range to prevent excessive bleeding or clotting.

A. Inform the client that oatmeal contains gluten. B. Encourage the client to choose decaffeinated coffee. C. Commend the client for selecting fat free milk. D. Advise the client that too much fruit can irritate the colon.

Correct Answer is A

Explanation

Choice A: Oatmeal is often considered a source of gluten, which should be avoided by individuals with celiac disease. The nurse should inform the client that oatmeal may not be suitable for a gluten-free diet.

Choice B: Encouraging the client to choose decaffeinated coffee is a minor consideration and is not the most important action related to celiac disease.

Choice C: Commending the client for selecting fat-free milk is unrelated to the issue of gluten in the oatmeal and is not the most important action.

Choice D: Advising the client about the potential irritant effects of too much fruit on the colon is not directly related to the issue of gluten in the oatmeal and is not the most important action.

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While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who was recently diagnosed with atrial fibrillation is receiving warfarin. To see the drug's effectiveness, which laboratory finding should the practical nurse (PN) review?

Correct Answer is D

Explanation

A client with celiac disease selects a bowl of oatmeal with fresh fruit and skim milk, grapefruit juice, and coffee from the breakfast menu. Which action is most important for the nurse to implement?

Correct Answer is A

Explanation

A 37-year-old client diagnosed with chronic kidney disease (CKD) is being treated for renal osteodystrophy. Which nursing diagnosis is most likely to be included in this client's plan of care?

When conducting diet teaching for a client who is on a gastrostomy tube feeding, which foods should the nurse encourage the client use? (Select all that apply.)

An adolescent hospitalized with sickle cell anemia reports to the nurse of experiencing a pain level of 10 on a 0 to 10 numerical scale. The nurse observes the adolescent on a phone call laughing. Which action should the nurse take?

A client reports feeling numbness and tingling in the extremities. Which of the client's serum laboratory values should the practical nurse (PN) review before reporting the finding?

A client tells the nurse about taking a variety of herbal products, including milk thistle, and has lost about thirty pounds over the last month. Which action should the nurse implement?

In conducting community health teaching, the nurse plans to describe foods that will help prevent rickets. What food product should the nurse recommend as the best dietary source for preventing rickets?

A community health nurse is concerned about the incidence of asthma among preschool aged children in a metropolitan area. Which intervention reflects a primary prevention strategy the nurse might initiate to combat this chronic illness?