A client is being weaned from total parenteral nutrition (TPN) and is expected to begin taking solid food today. The ongoing solution rate has been 100mL/hour. The nurse anticipates a change in orders regarding the TPN solution.

A decrease in the TPN rate

Start 0.9% normal saline at 25 mL/hour

Continue the current infusion rate prescription for TPN

Discontinue the TPN

Answer and Explanation

The Correct Answer is A

Rationale:
A. TPN should be gradually decreased as the client begins taking oral nutrition to prevent hypoglycemia, which can occur if TPN is stopped abruptly.
B. Starting normal saline is not a substitute for tapering TPN and does not provide the needed dextrose or nutrients.
C. Continuing the full TPN rate while beginning oral intake can lead to overfeeding or fluid overload.
D. Discontinuing TPN suddenly can cause significant metabolic disturbances, especially hypoglycemia. A gradual decrease is the safest and most appropriate intervention.

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Correct Answer is D

Explanation

Rationale:
A. Applying heat in the first 24–48 hours after a sprain can increase swelling and is not recommended. Cold therapy (ice) is preferred initially to reduce inflammation.
B. Wrapping should start from the toes and move upward toward the knee to promote venous return and proper compression, not from the knee down.
C. Bearing weight too soon can worsen the injury; rest and limited movement are advised initially.
D. Applying ice during the first 24–48 hours helps reduce swelling and pain, and is an appropriate self-care measure for a recent ankle sprain, indicating proper understanding of discharge instructions.

A. "I will make sure I get enough exposure to sunlight to keep my vitamin D levels up B. "I will try to be as physically active as possible between flare-ups C. I will make sure to monitor my body temperature on a regular basis" D. I will stop taking my steroids when I get relief from my symptoms.

Correct Answer is C

Explanation

Rationale:
A. Sunlight exposure can trigger flares in clients with SLE due to photosensitivity; minimizing UV exposure is recommended.
B. While moderate activity is beneficial, overexertion can lead to flares; clients should balance activity with rest.
C. Monitoring body temperature regularly helps detect early signs of infection, which clients with SLE are at increased risk for due to immunosuppressive therapy and the disease itself. This shows appropriate understanding.
D. Stopping steroids abruptly can lead to adrenal insufficiency and flare-ups; medications should only be adjusted under medical supervision.

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A client is being weaned from total parenteral nutrition (TPN) and is expected to begin taking solid food today. The ongoing solution rate has been 100mL/hour. The nurse anticipates a change in orders regarding the TPN solution.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discharging a client who came to the outpatient clinic with an ankle sprain. Which of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

Correct Answer is D

Explanation

A client with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the client has understood health education when the client makes what statement?

Correct Answer is C

Explanation

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