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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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Obtaining a walker does not address the acute neurological symptoms.

B. Applying a diaper addresses the incontinence but not the underlying cause.

C. Inserting a Foley catheter manages urinary incontinence but delays necessary evaluation.

D. Notifying the physician is critical as these symptoms suggest cauda equina syndrome, a surgical emergency.

A. A 43 year old female with lupus. B. A 55 year old male that works as a teacher. C. A 40 year old female that works at the chemical plant D. A 38 year old male whose father has Scleroderma

Correct Answer is B

Explanation

A. Lupus is associated with a higher risk of autoimmune conditions, including Scleroderma.

B. A male working as a teacher is less likely to have occupational or genetic predispositions for Scleroderma.

C. Chemical exposure can increase the risk of developing Scleroderma.

D. A family history of Scleroderma raises the genetic risk of developing the condition.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

The nurse is assessing clients for their risk of developing Scleroderma. Which of these clients should the nurse consider at lowest risk?

Correct Answer is B

Explanation

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)

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 client with newly diagnosed rheumatoid arthritis asks the nurse what happens to the joint with this disease. Which explanation by the nurse is most accurate?

A client fractured the right ankle which was casted with a plaster of Paris cast. Before discharge, the nurse gives instructions for cast care. Which statement made by the client indicates that further teaching is needed?

Which of these deformities is associated with osteoarthritis? (SELECT ALL THAT APPLY).

The nurse is caring for a client newly diagnosed with Clostridium difficile. This client should be placed on which type of precautions?

The patient is post-op day 1 of a right total hip replacement. What precautions are necessary to prevent complications? (SELECT ALL THAT APPLY).

The nurse understands that the placement of a pillow under the knee of a client with a total knee replacement is contraindicated because it will: