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A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?
- A. A client who is postoperative following a laminectomy and is receiving IV PCA
- B. A client who has dysphagia and does not recognize his family
- C. A client who has COPD and is going home with oxygen
- D. A client who has colon cancer and will undergo a hemicolectomy
Correct Answer: D
Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.
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A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?
- A. Administer enteral feedings
- B. Limit intake of vitamin C
- C. Limit dietary protein
- D. Administer insulin prior to meals
Correct Answer: A
Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.
A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?
- A. This does not mean that my baby will have this disease.
- B. This means that I will have diabetes for the rest of my life.
- C. If I feel dizzy, I should drink six ounces of a non-diet soda.
- D. Being obese might be one reason why I developed diabetes.
Correct Answer: B
Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.
A healthcare professional is reviewing the lab results of a client who has bulimia nervosa. The professional should notify the provider of which of the following results?
- A. White Blood Cells 5,200/mm³
- B. Hemoglobin 14 g/dL
- C. Magnesium 1.6 mg/dL
- D. Potassium 3.2 mEq/L
Correct Answer: D
Rationale: A potassium level of 3.2 mEq/L is below normal and requires provider notification, especially in clients with bulimia nervosa who are at risk of electrolyte imbalances. Low potassium levels can lead to serious complications like cardiac arrhythmias. The other options are within or close to the normal range and would not be a priority for notification.
A nurse is teaching a client about strategies to prevent constipation. Which of the following statements by the client indicates an understanding of the teaching?
- A. Drinking four to five glasses of water per day will prevent constipation.
- B. I should consume mineral oil once per day.
- C. Eating foods high in fiber will make elimination easier.
- D. I can skip a meal if I feel bloated.
Correct Answer: C
Rationale: The correct answer is C. Eating foods high in fiber increases stool bulk and promotes easier elimination, thus preventing constipation. Choices A, B, and D are incorrect. Drinking water is important, but the emphasis should be on high-fiber foods. Mineral oil is not a recommended first-line treatment for constipation, and skipping meals can disrupt regular bowel movements, potentially leading to constipation.
A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?
- A. Client has soft, formed bowel movements.
- B. Client's mucous membranes are pink.
- C. Client reports ability to complete ADLs.
- D. Client's blood glucose level is within the expected reference range.
Correct Answer: D
Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.