A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)

Serum phosphorus

Serum blood glucose

Serum calcium

Serum potassium

Serum magnesium

Answer and Explanation

Correct Answer : A,C,D,E

A. Serum phosphorus is crucial to monitor in patients at risk for refeeding syndrome. Hypophosphatemia is a key sign of the syndrome and can lead to severe complications, such as respiratory failure and cardiac arrhythmias.
B. Serum blood glucose levels are important to monitor, especially since refeeding syndrome can cause rapid shifts in glucose metabolism. However, it is not a primary test to diagnose refeeding syndrome. Blood glucose monitoring will be part of the overall management, but not the core test for the syndrome.
C. Serum calcium should be monitored because it can also decrease in refeeding syndrome due to shifts in phosphate and magnesium levels, which may affect calcium metabolism.
D. Serum potassium is essential to monitor because hypokalemia often occurs in refeeding syndrome as the body shifts electrolytes into cells. This can cause muscle weakness, arrhythmias, and other serious complications.
E. Serum magnesium is also important to check, as hypomagnesemia is commonly seen in refeeding syndrome and can contribute to neurological and cardiac symptoms.

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Correct Answer is B

Explanation

A. Epigastric discomfort is a common symptom of peptic ulcer disease, but it is not the priority finding. This symptom is usually manageable with appropriate treatment, such as antacids or proton pump inhibitors.
B. Hematemesis (vomiting blood) is a critical finding and indicates active bleeding, which can be life-threatening. This requires immediate attention as it suggests a potential complication, such as ulcer perforation or severe gastric bleeding, that can lead to hypovolemic shock. It is the priority finding because it indicates the need for urgent medical intervention.
C. Constipation is not a priority concern in a patient with peptic ulcer disease unless it is severe and related to medication (such as opioids). While it may be uncomfortable, it does not pose the immediate risk that hematemesis does.
D. Dyspepsia, or indigestion, is another common symptom of peptic ulcer disease. While it can be bothersome, it does not represent an acute, life-threatening issue like hematemesis does.

A. 3% sodium chloride B. Lactated Ringer's C. 0.9% sodium chloride D. Dextrose 10% in water

Correct Answer is D

Explanation

A. 3% sodium chloride is a hypertonic solution used to treat severe hyponatremia and should not be used as a substitute for TPN.
B. Lactated Ringer's is an isotonic solution typically used for fluid resuscitation, but it lacks the necessary components (glucose, amino acids) that are found in TPN.
C. 0.9% sodium chloride is an isotonic saline solution and can be used for hydration, but it does not provide the calories and nutrients that the client is receiving through TPN.
D. Dextrose 10% in water is the best choice in this scenario. It provides glucose for energy and can help maintain blood sugar levels until the next TPN solution is available. It is commonly used as a temporary substitute for TPN to prevent hypoglycemia.

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A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

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