A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Administer the PN and fat emulsion separately.

Change the PN infusion bag every 48 hr.

Obtain a random blood glucose daily.

Prepare the client for a central venous line

Answer and Explanation

The Correct Answer is D

. PN with 20% dextrose requires a central venous line for administration. Peripheral veins cannot handle the high osmolarity of such solutions, which can cause phlebitis and vein damage. A central venous line is necessary to deliver the solution safely into a larger vein with a higher blood flow.
A. Fat emulsions (lipids) are often administered separately from the PN solution, but they can also be infused concurrently through a Y-connector to minimize the risk of contamination. However, it is crucial to follow the specific guidelines of the healthcare facility and the manufacturer’s recommendations. The decision to administer separately or concurrently depends on the prescribed protocol.
B. PN solutions are typically changed every 24 hours to reduce the risk of infection. The high glucose content in PN solutions provides a rich medium for bacterial growth, making it essential to adhere to strict aseptic techniques and timely changes of the infusion bag.
C. Blood glucose monitoring is crucial for clients receiving PN due to the high dextrose content, which can significantly impact blood glucose levels. However, more frequent monitoring, such as every 4-6 hours initially, is often required rather than just a random daily check. This helps in promptly identifying and managing hyperglycemia or hypoglycemia.

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

Explanation

B. Vitamin D level- Low levels of vitamin D, as indicated by the client's 25-hydroxy D (vitamin D + D) levels below the reference range (24 ng/dL initially and 15 ng/dL at the 6-month follow-up), can contribute to osteoporosis. Vitamin D is essential for calcium absorption and bone health.

D. Activity level- The client reports a sedentary lifestyle and inability to exercise regularly. Lack of weight-bearing exercise can increase the risk of osteoporosis as weight-bearing exercises help maintain bone density.
A. Alcohol use- The client denies drinking alcohol, so alcohol use is not a risk factor in this case.
C. Lactose intolerant- Lactose intolerance does not directly increase the risk of osteoporosis. However, if the client avoids dairy products due to lactose intolerance, they may have lower calcium intake, which can affect bone health.
E. Smoking history- The client is described as a nonsmoker, so smoking is not a risk factor for osteoporosis in this case. Smoking is associated with decreased bone density and increased fracture risk.
F. Phosphorus level- Phosphorus levels within the normal range (3.4 mg/dL initially and 3.2 mg/dL at the 6-month follow-up) do not directly indicate increased risk for osteoporosis. However, phosphorus, along with calcium, is important for bone health.

A. "Why are you feeling scared about being in this facility? B. "Most people are scared their first time in a health care facility." C. "You have nothing to worry about. Everything will be fine." D. "We can discuss what you can expect during your stay."

Correct Answer is D

Explanation

D. acknowledges the client's anxiety and offers support by suggesting a discussion about what to expect during their stay. This statement promotes open communication and collaboration between the nurse and the client, allowing the client to express their concerns and receive information that may alleviate their anxiety.

A. may come across as confrontational or dismissive of the client's feelings. While understanding the root cause of the client's anxiety is important, this approach may not be the most effective way to address their immediate concerns.

B. may unintentionally minimize the client's feelings by suggesting that their anxiety is common or expected. While it is true that many people experience anxiety when admitted to a healthcare facility, acknowledging the client's individual experience and providing personalized support is essential.

C. provides reassurance but may be perceived as dismissive or invalidating of the client's feelings. It does not address the client's specific concerns or offer support in coping with their anxiety.

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A nurse is caring for a client

Exhibits

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A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a client. Exhibits The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for osteoporosis? (Select all that apply.)

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

Explanation

A nurse is caring for a client who is anxious about being admitted to a health care facility for the first time. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

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A nurse identifies a small fire in a client's room. After moving the client to safety, which of the following is the next action the nurse should take?

A nurse is caring for a client Exhibits

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