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?
Urinary ketones.
Serum protein.
Serum osmolarity.
Capillary glucose.
The Correct Answer is D
Correct answer: D
Choice A
Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.
Choice B
Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.
Choice C
Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is important to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN. Blood glucose levels (option D) are more critical because TPN can significantly impact glucose metabolism
Choice D
When caring for a client receiving total parenteral nutrition (TPN), the nurse’s priority is to monitor blood glucose levels. TPN can affect blood glucose, and observing for signs of hyperglycemia or hypoglycemia is crucial. Additionally, administering insulin as directed based on blood glucose levels is essential.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A
Counting carbohydrates will ensure glucose levels stay within a normal range is accurate. When providing dietary education to a client with Type 2 diabetes mellitus, it's important to emphasize the role of carbohydrate counting in managing blood glucose levels. Carbohydrate intake significantly impacts blood sugar levels, and counting carbohydrates can help the client make informed decisions about their meals and medications to maintain glucose levels within a normal range.
Choice B
Many carbohydrates are found in starches and fruits is not accurate. Carbohydrates are present in a variety of foods, including starches (such as bread, rice, and pasta) but not fruits. Educating the client about sources of carbohydrates can help them make choices that support blood sugar management.
Choice C
It is best to count carbohydrates when it feels like blood glucose is low is not accurate. Counting carbohydrates is an ongoing practice that helps individuals with diabetes maintain consistent blood sugar levels throughout the day, not just when blood glucose feels low.
Choice D
Examples of complex carbohydrates are white rice and cereals is inaccurate. White rice and many cereals are actually exampling of simple carbohydrates. Complex carbohydrates include foods like whole grains, legumes, and vegetables. It's important to provide accurate information about carbohydrate types.
Correct Answer is B
Explanation
Choice A
Advising the client that too much fruit can irritate the colon is not the right choice. While it's true that excessive consumption of certain fruits can cause gastrointestinal discomfort, this information is not directly related to celiac disease or the selected meal.
Choice B
Informing the client that oatmeal contains gluten is the right choice. Celiac disease is an autoimmune disorder in which consuming gluten, a protein found in wheat, rye, and barley, triggers an immune response that damages the small intestine. Oatmeal itself is naturally gluten-free, but it is often processed in facilities that also process gluten-containing grains, which can lead to cross-contamination. Therefore, it's important for individuals with celiac disease to choose certified gluten-free oats to avoid adverse reactions.
Choice C
Commending the client for selecting fat-free milk is not the best choice. While choosing a healthier milk option is beneficial for overall health, it is not the most important action in this situation, considering the client's celiac disease.
Choice D reason;
Encouraging the client to choose decaffeinated coffee is not the right choice. The choice of caffeinated or decaffeinated coffee is a matter of preference and is not directly related to celiac disease or the potential for gluten exposure from the oatmeal.
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