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. Check the client's pain level B. Assess for bowel sounds and ask the client if she has passed any flatus C. Put the client on a clear liquid diet D. Administer an antiemetic

Correct Answer is B

Explanation

Rationale:
A. While pain assessment is important, nausea and vomiting post-hysterectomy may indicate gastrointestinal issues that need immediate evaluation.
B. Assessing bowel sounds and asking about flatus helps determine if the gastrointestinal tract is functioning properly, which is critical before advancing diet or administering medications. This should be the first action.
C. Changing the diet to clear liquids may be appropriate but only after assessing GI status.
D. Administering an antiemetic can help symptoms but should follow assessment to rule out underlying issues such as ileus or obstruction.

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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 nurse is caring for a client who had a hysterectomy and resumed a regular diet earlier in the day. The client is now reporting nausea and has vomited once. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

The nurse instructs the client with gastroesophageal reflux disease (GERD) regarding dietary measures. Which action demonstrates that the client has understood the recommended dietary changes?

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