An 18-year-old first year college student is admitted to a medical telemetry unit due to a near syncopal episode at the residence hall. The patient has a history of anxiety, obsessive-compulsive disorder & anorexia nervosa. Their body mass index is 16.7 today. Based on lab data, a right subclavian triple lumen catheter is placed to give total parenteral nutrition (TPN). Ninety minutes after the infusion started, the patient reports muscle cramping, headache & visual changes. Based on these findings, the nurse & healthcare team's highest priority is possible

refeeding syndrome.

sudden hyperglycemia

air embolus.

acute panic attack.

Answer and Explanation

The Correct Answer is A

A. Refeeding syndrome occurs when a malnourished patient is given nutrition (such as TPN), leading to electrolyte imbalances (particularly low phosphorus, potassium, and magnesium) that can cause symptoms like muscle cramping, headache, and visual changes. This condition requires immediate correction of electrolyte imbalances and careful monitoring.

B. Sudden hyperglycemia can occur with TPN, but the symptoms described (muscle cramping, headache, and visual changes) are more consistent with refeeding syndrome.

C. An air embolus is a serious complication but is less likely to be the cause of these symptoms.

D. Acute panic attacks could cause some of the symptoms, but the patient's low BMI and history of anorexia nervosa make refeeding syndrome the more likely cause.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is ["B","C","E"]

Explanation

A. A diet high in fiber is important to prevent constipation, a common side effect of opioid use.

B. Adequate fluid intake helps to prevent dehydration and constipation.

C. Taking a stool softener daily can help mitigate the constipating effects of opioids.

D. While dizziness can occur, clients should be encouraged to maintain an appropriate level of activity with precautions.

E. Taking the opioid with a full glass of water and sitting upright can help prevent esophageal irritation and ensure proper swallowing of the medication.

A. "I would suggest the use of any available remedy that might give you some comfort. B. "Let's discuss some of your concerns." C. "The changes will be subtle at first, so they won't be noticeable to others." D. "It is hard to predict what the disease process has in store for any one individual."

Correct Answer is B

Explanation

A. Suggesting remedies prematurely without fully understanding the client’s concerns might not address their specific needs.

B. The best response is to encourage open communication by acknowledging the client’s concerns and fostering a discussion. This approach helps the nurse understand the client’s worries and provide tailored information about rheumatoid arthritis and its potential impact on daily life.

C. The progression of rheumatoid arthritis is variable and can affect activities of daily living more noticeably over time; it’s not always subtle.

D. While predicting disease outcomes can be difficult, giving a more open response like option B will foster better communication and support.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following teaching instructions should be included for the patient with newly prescribed opioid analgesic for pain? (SELECT ALL THAT APPLY).

Correct Answer is ["B","C","E"]

Explanation

The client has been diagnosed with rheumatoid arthritis and asks, "What impact will this have on my activities of daily living in the years to come?" What is the best response by the nurse?

Correct Answer is B

Explanation

A client has been prescribed a full liquid diet following surgery. Which items should the nurse remove from the client's tray? (SELECT ALL THAT APPLY)

The nurse teaches a client that which factor might increase the risk of developing an exacerbation of systemic lupus erythematous (SLEP

A client is admitted with a dislocation of the right shoulder. The nurse knows this is an orthopedic emergency and that the priority for treatment will be:

A client has been treated for low back pain which radiates down the posterior right leg. The client now has a new onset of urinary and bowel incontinence and weakness in both lower extremities. What is the nurse's first action?

The client has fibromyalgia and asks the nurse why this occurs. Which statement by the client, would show that the explanation was understood?

Which of these education points would be MOST helpful for the nurse give to a individual with osteoarthritis? (SELECT ALL THAT APPLY).

A nurse is caring for a client with a herniated disc who has undergone a lumbar laminectomy and diskectomy at L4-5. When assisting the client to move in bed, the nurse should include what specific technique?

A nurse is caring for a client postoperative closed reduction of the left ankle with a short cast in place. Which assessments of the client's affected leg should the nurse make? (SELECT ALL THAT APPLY)