TEST BANK FOR NURSING INTERVENTIONS AND CLINICAL SKILLS 7TH EDITION BY POTTER
Chapter 14: Parenteral Nutrition Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition MULTIPLE CHOICE 1. The nursing assistive personnel (NAP) reports that a patient receiving parenteral nutrition via
a central line is coughing and short of breath. Which action by the nurse is the priority? a. Clamp the IV tubing. b. Call for a chest x-ray. c. Notify the provider. d. Check a bedside glucose. ANS: A
This patient has manifestations of an air embolus. The nurse would first clamp the IV tubing to prevent more air from entering the tube. The nurse will notify the provider and perhaps call for a chest x-ray, but the priority is to stop the problem. A bedside glucose is not warranted. DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
OBJ: NCLEX: Physiological Integrity
2. A nursing student is teaching a patient about lab testing that will be done frequently while the
patient is on parenteral nutrition. Which statement by the student requires the registered nurse to intervene? a. “Your copper and zinc levels may change rapidly.” b. “We will check your protein levels about weekly.” c. “The staff will check your blood glucose frequently at first.” N d. “Your white blood cell count can help us assess for infection.” ANS: A
Trace elements such as copper and zinc are usually tested monthly or biannually because they do not fluctuate rapidly. The nurse would intervene to correct the student. The other statements are accurate. DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation
OBJ: NCLEX: Physiological Integrity
3. A patient has been receiving parenteral nutrition (PN) via a central line that has now occluded.
The patient also has a midline catheter. What modification of the PN does the nurse ensure prior to switching the PN to the midline catheter? a. Holding the lipid infusion b. Ensuring osmolality is less than 900 mOsm c. Doubling the insulin concentration d. Cutting the total fluid volume to 1500 mL ANS: B
PN formulations with an osmolality of greater than 900 mOsm should not be infused through midline, peripheral, or midclavicular lines due to the increased risk of phlebitis. Lipids can run through a midline catheter. There is no reason to double the insulin. Peripheral PN is usually delivered in a higher fluid volume than TPN, of about 2000–3000 mL.
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