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.

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Correct Answer is A

Explanation

A. The priority in treating a dislocated joint is to realign the dislocated bones to their proper position, which is crucial to prevent damage to the surrounding nerves, blood vessels, and muscles. This should be done promptly under medical supervision, often requiring sedation or pain management.

B. Teaching the client to avoid contact sports is important for long-term care, but not an immediate priority in the acute phase.

C. Applying a sling helps support the joint, but it is not the first priority; realignment of the joint is more urgent.

D. Letting the joint return to its position on its own may result in complications and should not be relied upon.

A. Enzymatic medication B. Oxygen therapy C. Anti-coagulation therapy D. Physical therapy E. "Safe gradual weight loss will decrease stress on your joints."

Correct Answer is B

Explanation

A. Enzymatic medications are not relevant to this condition.

B. Oxygen therapy is critical as these symptoms suggest fat embolism syndrome, which impairs oxygenation.

C. Anticoagulation therapy is not appropriate for fat embolism syndrome, which differs from thromboembolism.

D. Physical therapy is not an immediate intervention for this acute condition.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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:

Correct Answer is A

Explanation

The nurse is caring for a client who has sustained multiple injuries, including a fractured pelvis and femur. Two days later, the client becomes restless and confused. The nurse notes petechiae on the client's neck and chest. The nurse should expect which physician order?

Correct Answer is B

Explanation

Which are examples of primary prevention techniques to decrease falls that the nurse could suggest for older adults who are living in their own homes? (SELECT ALL THAT APPLY)

A nurse is caring for a client who is experiencing acute back pain and who was given a medical prescription for a nonsteroidal anti-inflammatory agent (NSAID). The nurse would monitor the client for which symptom?

A nurse is caring for a client with osteoarthritis. The nurse should expect which findings with this disease process?

Your neighbor returns home from the Emergency Department following treatment for a right ankle sprain and asks you, a nurse, to explain what will happen now that he is home. You recognize that continuing short term treatment will most likely include: (SELECT ALL THAT APPLY)

The nurse is presenting a community health program on fracture risk reduction. Which topics should be included? (SELECT ALL THAT APPLY)

A client is receiving IV fluids at 100 ml per hour. The nurse is told in report at 1200 that there are 500 ml left in the bag. At what time should the nurse expect to hang a new bag? Report the time in military time.

A client with osteoarthritis of the left knee will undergo an injection of corticosteroids into the joint. The nurse notes that the primary reason for this injection is to:

A client with traumatic injuries has a comminuted open fracture of the femur that has been placed in an external fixator. The nurse recognizes that compartment syndrome is associated with which clinical assessment finding?