A patient is admitted with severe malnutrition. A central venous catheter is placed in the right subclavian vein and total parenteral nutrition (TPN) is started. What medical interventions may be initiated with the onset of hyperglycemia?

Adding insulin to the TPN

Discontinuing the infusion

Weaning from the TPN over a 6-hour period

Starting an infusion of 0.9% normal saline

Answer and Explanation

The Correct Answer is A

A. Insulin can be added to the TPN to control blood sugar levels. TPN often leads to hyperglycemia, and insulin is commonly added to the solution to regulate glucose levels.
B. Discontinuing the infusion would not address the hyperglycemia and would risk nutrient deficiencies.
C. Weaning from TPN may be indicated when discontinuing the nutrition support, but it is not a direct intervention for hyperglycemia.
D. Starting an infusion of 0.9% normal saline would not address the hyperglycemia directly and may not be effective in managing the glucose levels.

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Correct Answer is B

Explanation

A. Autonomy refers to respecting the patient’s right to make their own decisions. While important, it is not the ethical principle that guides the nurse's decision to report the situation to Adult Protective Services.
B. Nonmaleficence refers to the duty to do no harm. Reporting the neglect of the client to Adult Protective Services is consistent with preventing further harm and ensuring the client’s safety.
C. Justice refers to fairness and equal treatment. While the nurse is working to protect the client, the situation involves more than just fairness, making nonmaleficence the more applicable principle.
D. Fidelity refers to loyalty and keeping promises, but it does not specifically guide the nurse’s action in this situation.

A. Chlordiazepoxide and folic acid B. Promethazine and thiamine C. Chlordiazepoxide and lorazepam D. Lorazepam and promethazine

Correct Answer is C

Explanation

A. Chlordiazepoxide is a benzodiazepine used for alcohol withdrawal, but folic acid is not commonly used for managing withdrawal symptoms.
B. Promethazine is an antiemetic, and thiamine is given to prevent Wernicke's encephalopathy, but they are not primarily used to manage withdrawal symptoms.
C. Chlordiazepoxide and lorazepam are both benzodiazepines that are commonly used to manage alcohol withdrawal symptoms by calming the nervous system and preventing seizures or delirium tremens.
D. Lorazepam is appropriate, but promethazine is not typically used to treat alcohol withdrawal symptoms.

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A patient is admitted with severe malnutrition. A central venous catheter is placed in the right subclavian vein and total parenteral nutrition (TPN) is started. What medical interventions may be initiated with the onset of hyperglycemia?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse in the ICU is caring for a client who was found unresponsive on a sidewalk. The client's blood alcohol level was three times the normal range. Which medications are commonly used for alcohol withdrawal symptoms?

Correct Answer is C

Explanation

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