What should the nurse assess the patient for after discontinuing the TPN?
Hypoglycemia.
Hyperthermia.
Flatulence.
Tachycardia.
The Correct Answer is A
Choice A rationale
Abrupt cessation of total parenteral nutrition (TPN) can lead to a rapid decrease in blood glucose levels. While receiving TPN, the body is continuously supplied with glucose. When this external glucose source is suddenly removed, the pancreas may continue to secrete insulin at a rate higher than needed, resulting in hypoglycemia. Signs and symptoms of hypoglycemia include sweating, tremors, confusion, and dizziness.
Choice B rationale
Hyperthermia, or elevated body temperature above the normal range of approximately 36.5°C to 37.5°C (97.7°F to 99.5°F), is not a typical complication following the discontinuation of TPN. Fever is usually associated with infection or inflammation, neither of which are a direct consequence of stopping TPN.
Choice C rationale
Flatulence, or the accumulation of gas in the digestive tract leading to bloating and the passage of gas, is related to dietary intake and digestive processes. Discontinuing TPN, which bypasses the digestive system, would not directly cause an increase in flatulence. In fact, digestive issues might improve once oral or enteral feeding resumes.
Choice D rationale
Tachycardia, an abnormally rapid heart rate (typically defined as above 100 beats per minute in adults), is not a direct physiological consequence of discontinuing TPN. While changes in fluid balance or electrolyte levels (which can occur with TPN but are monitored closely) could indirectly affect heart rate, hypoglycemia is a more immediate and direct risk upon TPN cessation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Minimizing the use of seasoning can decrease palatability and potentially reduce the client's food intake, negatively impacting their nutritional status. Flavorful foods can stimulate appetite and encourage better nutrient consumption.
Choice B rationale
Limiting finger foods may restrict autonomy and reduce intake for clients who have difficulty using utensils. Finger foods can provide independence and increase caloric intake for some individuals in long-term care.
Choice C rationale
Serving small, frequent meals can improve nutritional intake by preventing early satiety and providing a consistent supply of nutrients throughout the day. This approach is often beneficial for individuals with decreased appetite or difficulty tolerating large meals.
Choice D rationale
Offering three large meals daily might be overwhelming for some clients in long-term care who may have reduced appetites, slower digestion, or other medical conditions that make it difficult to consume large quantities of food at once.
Correct Answer is ["B","E","C"]
Explanation
Choice A rationale
Hyperresonance is a booming sound elicited during percussion, typically heard over hyperinflated lung tissue, such as in emphysema or pneumothorax. In the abdominal assessment, hyperresonance is generally not an expected finding and may indicate gaseous distension.
Choice B rationale
Flatness is a dull, very soft sound with a short duration, usually heard over dense tissues such as bone or muscle. In the abdomen, flatness is not a typical percussion sound and might be elicited over a large tumor or organomegaly.
Choice C rationale
Dullness is a thud-like sound with a medium intensity and duration, typically heard over solid organs such as the liver, spleen, or a distended bladder. In the abdominal assessment, dullness is an expected finding over these organs.
Choice D rationale
Resonance is a hollow sound of moderate duration and low pitch, typically heard over normal lung tissue. Resonance is not an expected percussion sound in the abdominal assessment; tympany and dullness are the predominant sounds.
Choice E rationale
Tympany is a drum-like sound with high pitch and longer duration, commonly heard over air-filled structures such as the stomach and intestines. Tympany is the predominant percussion sound expected over most of the abdomen due to the presence of gas in the gastrointestinal tract.
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