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 B

Explanation

B. Toxic megacolon is characterized by severe colonic dilation, leading to a significant increase in abdominal girth. As the colon becomes distended, it can cause visible abdominal swelling and bloating, which may be accompanied by tenderness upon palpation.
A. In the context of toxic megacolon, there may be a reduction or cessation of bowel movements due to colonic dilation and paralysis.
C. In toxic megacolon, bowel sounds may initially be hyperactive due to increased peristalsis as the colon attempts to overcome the obstruction. However, as the condition progresses, bowel sounds may diminish or become absent due to colonic dilation and paralysis.
D. While fever can be present in toxic megacolon due to the underlying inflammatory process, it is not universally seen in all cases.

A. "High fat foods should make up at least 50% of your intake." B. "Choose foods high in fiber to promote bowel function." C. "You will need to maximize your protein intake." D. "Fluids and food should be ingested together to help with absorption."

Correct Answer is C

Explanation

C. Protein is essential for tissue repair and maintenance, especially after surgery. Adequate protein intake can also help preserve muscle mass and promote satiety, which can be beneficial for weight management. However, it's important to choose lean protein sources and monitor portion sizes to avoid overconsumption.
A. After gastric banding (Lap-band) surgery, it is generally recommended to avoid high-fat foods. High-fat foods can contribute to weight gain and may increase the risk of complications such as dumping syndrome, which occurs when food moves too quickly from the stomach to the small intestine.
B. Adequate fiber intake is important for promoting bowel regularity and preventing constipation, which can be a concern after gastric banding surgery. However, it's essential to choose low-calorie, high-fiber foods to avoid overeating and to support weight loss goals.
D. After gastric banding surgery, it's generally recommended to avoid drinking fluids with meals. Consuming fluids during meals can cause the stomach pouch to fill too quickly, leading to discomfort and potentially stretching the pouch over time. It's typically advised to wait at least 30 minutes to 1 hour after meals before drinking fluids.

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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:

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Naxlex Comprehensive Predictor Exams

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