The nurse is providing care to a patient admitted with an exacerbation of Crohn's disease and a history of diabetes. The patient is receiving total parenteral nutrition (TPN) through a central venous access device. Which intervention will the nurse implement while caring for this patient?

Administer lipid injectable emulsion with TPN every day based on albumin results.

Disconnect IV tubing and add regular insulin to TPN bag based on the sliding scale results.

Maintain aseptic technique when changing tubing or parenteral nutrition bag.

Administer dextrose infusion through a separate tubing three hours before discontinuing TPN.

Answer and Explanation

The Correct Answer is C

Choice A reason: Administering lipid injectable emulsion with TPN every day based on albumin results is not the priority intervention. While lipid emulsions may be part of TPN, the focus should be on maintaining aseptic technique to prevent infection.

Choice B reason: Disconnecting IV tubing and adding regular insulin to the TPN bag based on sliding scale results is not appropriate. Insulin should be administered separately, and aseptic technique must be maintained to prevent contamination.

Choice C reason: Maintaining aseptic technique when changing tubing or the parenteral nutrition bag is crucial for preventing infection. Patients receiving TPN through a central venous access device are at high risk for infections, and strict aseptic technique is essential.

Choice D reason: Administering dextrose infusion through separate tubing three hours before discontinuing TPN is not a standard practice. The focus should be on proper administration and infection control practices.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Advising the patient to consume protein and carbohydrates immediately is not appropriate in this context. The presence of ketones in the urine indicates that the body is using fat for energy due to a lack of insulin. Increasing carbohydrate intake without addressing the underlying insulin deficiency can worsen hyperglycemia and ketoacidosis.

Choice B reason: Notifying the provider of the result and recommending that the patient's insulin dose be increased is the appropriate intervention. The presence of ketones in the urine indicates inadequate insulin levels, and adjusting the insulin dose can help correct the metabolic imbalance and prevent further complications such as diabetic ketoacidosis.

Choice C reason: Instructing the patient to withhold the next scheduled dose of insulin is incorrect. Insulin is essential for managing blood glucose levels and preventing ketosis in patients with type 1 diabetes. Withholding insulin can lead to severe hyperglycemia and ketoacidosis.

Choice D reason: Suggesting that the patient ask their provider to start them on metformin therapy is not appropriate for type 1 diabetes. Metformin is used primarily for type 2 diabetes and is not effective in type 1 diabetes, where insulin is required for glucose management.

A. Perform weekly occult blood testing with gastric analysis test. B. Discuss nutritional management with inclusion of a high-protein, high-vitamin diet. C. Leave ostomy site open to air for an hour each day when changing the appliance. D. Instruct the patient and family how to give medications through their G-tube.

Correct Answer is B

Explanation

Choice A reason: Performing weekly occult blood testing with gastric analysis is not typically required for managing IBD at home. While monitoring for blood in the stool can be important, weekly testing and gastric analysis are more invasive and usually performed under specific medical instructions rather than as a routine home care intervention.

Choice B reason: Discussing nutritional management with the inclusion of a high-protein, high-vitamin diet is crucial for patients with IBD. These patients often experience malnutrition due to poor absorption and increased nutritional needs during flare-ups. A high-protein, high-vitamin diet can help promote healing, maintain muscle mass, and prevent deficiencies. This intervention supports overall health and recovery.

Choice C reason: Leaving the ostomy site open to air for an hour each day when changing the appliance is not recommended. Ostomy sites need to be kept clean and protected to prevent infection and skin irritation. Instead, the focus should be on proper cleaning and secure application of the ostomy appliance.

Choice D reason: Instructing the patient and family on how to give medications through their G-tube is not relevant if the patient has an ostomy. A G-tube is used for feeding and medication administration in patients with impaired oral intake, which is not indicated in this scenario. The focus should be on ostomy care and management.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is providing care to a patient admitted with an exacerbation of Crohn's disease and a history of diabetes. The patient is receiving total parenteral nutrition (TPN) through a central venous access device. Which intervention will the nurse implement while caring for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a patient with type 1 diabetes. While reviewing the patient's laboratory results, the nurse notes the presence of ketones in the urine. What intervention will the nurse implement for this patient?

Correct Answer is B

Explanation

The nurse is creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient had an ostomy from a previous surgery. What interventions will the nurse include in this plan?

Correct Answer is B

Explanation

The nurse is caring for a patient who is being treated for idiopathic thrombocytopenic purpura (ITP). Which treatment will the nurse administer as part of this patient's management?

The nurse is caring for a patient with respiratory alkalosis. Which clinical manifestations will the nurse expect to find?

The nurse is caring for a patient with metabolic alkalosis. What will the nurse recognize as the common cause of this acid-base imbalance?

The nurse is caring for a patient who is lethargic and dehydrated. Arterial blood gas (ABG) results show pH 7.50, PaO2 85 mmHg, PaCO2 45 mmHg, HCO3 35 mEq/L. What acid-base imbalance will the nurse recognize the patient is at risk for?

The nurse is providing discharge education to a patient with iron deficiency anemia. The patient has been prescribed to take an oral iron supplement. What will the nurse include in the teaching for this patient? (Select All That Apply)

The nurse is caring for a patient with chronic kidney disease (CKD) who is at risk for renal osteodystrophy. Which intervention will the nurse implement to manage this condition?

The nurse has received SBAR report for their four assigned patients on a cardiac unit. Which patient will the nurse prioritize to assess first?