A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

serum white blood cell count of 16,000/mm3.

pre-albumin level less than 10 mg/dl

maintenance of baseline weight or gain of up to 1 kg/day.

negative nitrogen balance.

Answer and Explanation

The Correct Answer is C

C. The expected effect of TPN is to maintain or promote weight gain in clients who are unable to meet their nutritional needs orally. TPN provides essential nutrients directly into the bloodstream, allowing for adequate caloric intake to support energy needs and promote tissue repair and growth.
A. A serum white blood cell count of 16,000/mm3 indicates leukocytosis, which may suggest infection or inflammation rather than a direct effect of TPN.
B. Pre-albumin is a marker of nutritional status, and levels below 10 mg/dl typically indicate malnutrition rather than a positive response to TPN.
D. Negative nitrogen balance occurs when the body loses more nitrogen than it gains, typically due to inadequate protein intake or increased protein breakdown. TPN provides amino acids, which are the building blocks of protein, and aims to promote a positive nitrogen balance to support tissue repair and growth.

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Correct Answer is ["D","E"]

Explanation

D. Prophylactic antibiotics are often administered before surgery for appendicitis to reduce the risk of postoperative infection, particularly in cases of suspected or confirmed appendiceal perforation.
E. Keeping the client NPO (nothing by mouth) is a standard precaution before surgery to prevent aspiration of gastric contents during anesthesia induction and to reduce the risk of surgical complications.
A. Applying heat to the abdomen can potentially worsen inflammation and increase the risk of appendiceal rupture.
B. Ambulation may exacerbate the pain and increase the risk of complications, such as appendiceal rupture.
C. Administering a cleansing enema in preparation for surgery may be appropriate in some cases to help prepare the bowel for surgery, particularly if there is concern about bowel obstruction or to reduce the risk of contamination during surgery.

A. Loops of large bowel become visibly outlined through the abdominal wall B. Intense thirst, parched tongue and dry mucous membranes C. Vomiting of bile-stained gastric contents D. High-pitched, frequent bowel sounds

Correct Answer is A

Explanation

A. Loops of large bowel become visibly outlined through the abdominal wall is a typical late clinical finding of a large bowel obstruction. In fact, visible loops of bowel through the abdominal wall may be observed in cases of a severe bowel obstruction, but it is not typically considered a late finding.

B. Intense thirst, parched tongue, and dry mucous membranes suggest dehydration, which can occur as a result of vomiting, decreased fluid intake, or fluid loss due to the obstruction. However, dehydration may occur earlier in the course of a bowel obstruction and may not be considered a late finding.
C. Vomiting in large bowel obstruction is commonly of fecal contents.
D. High-pitched, frequent bowel sounds is not a typical late clinical finding of a large bowel obstruction. Instead, bowel sounds are usually diminished or absent in cases of bowel obstruction due to decreased peristalsis beyond the site of obstruction.

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A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has suspected appendicitis. While waiting for surgery, nursing interventions for this client would include: (NOTE: Assume that there are physician's orders for all interventions which would require them.) (SELECT ALL THAT APPLY)

Correct Answer is ["D","E"]

Explanation

The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

Correct Answer is A

Explanation

The nurse is teaching the client about successful strategies for weight loss. Which would the nurse include? (SELECT ALL THAT APPLY)

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