A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?

Schedules a bag and tubing change for 24 hr after the start of the infusion

Plans for a check of the client's fingerstick glucose level every 6 hr

Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved

Uses the TPN IV tubing to administer the client's next dose of antibiotics

Answer and Explanation

The Correct Answer is D

A: Changing the TPN bag and tubing every 24 hours is standard practice to prevent infection, so this action is appropriate.
B: Checking glucose levels every 6 hours is necessary because TPN can significantly affect blood glucose levels.
C: Gradually increasing the TPN rate is a standard procedure to monitor tolerance to the infusion.
D: This indicates a need for intervention. TPN lines should not be used for any other infusions to prevent contamination and interactions between the nutrition formula and medications.

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Correct Answer is C

Explanation

A. Using up to 40 nicotine lozenges per day is excessive and may lead to nicotine toxicity.

B. Substituting tobacco use with an electronic cigarette is not recommended due to potential health risks associated with vaping.
C. Nicotine replacement therapy, such as nicotine gum, should be used for a limited duration to avoid dependence. The nurse should educate the client to limit the use of nicotine gum to no more than 6 months to achieve smoking cessation goals effectively.
D. Using progressively larger nicotine patches is not a standard practice and may increase the risk of nicotine overdose.

A. Provocative behavior B. Lack of empathy C. Goal-oriented D. Lability

Correct Answer is C

Explanation

A. This is not characteristic of OCPD; such behavior is more associated with personality disorders that involve issues with impulse control and attention-seeking, such as histrionic personality disorder.
B. While people with OCPD might appear rigid or stubborn, a lack of empathy is more characteristic of antisocial or narcissistic personality disorders.
C. Individuals with obsessive-compulsive personality disorder (OCPD) are often highly focused on orderliness, perfectionism, and control, making them very goal- oriented and preoccupied with productivity.
D. Emotional lability is not a feature of OCPD; it is more often associated with borderline personality disorder, which includes rapid and intense emotional swings.

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A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?

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