Nokea
Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?
- A. They have a high energy-to-fluid-volume ratio.
- B. Even though hypertonic, they are well tolerated.
- C. They are a basic solution secondary to the addition of sodium hydroxide (NaOH).
- D. The pH is alkaline, making them compatible with most medications.
Correct Answer: A
Rationale: They have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories respectively for each milliliter. A milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices 2, 3, and 4 are incorrect because fat emulsions are essentially pH neutral and isotonic.
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If your patient is acutely psychotic, which of the following independent nursing interventions would not be appropriate?
- A. Conveying calmness with one on one interaction
- B. Recognizing and dealing with your own feelings to prevent escalation of the patient's anxiety level
- C. Encourage client participation in group therapy
- D. Listen and identify causes of their behavior
Correct Answer: C
Rationale: Acutely psychotic patients will disrupt group activities.
To improve overall health, the nurse should place highest priority on assisting a client to make lifestyle changes for which of the following habits?
- A. Drinking a six-pack of beer each day
- B. Eating an occasional chocolate bar
- C. Exercising twice a week
- D. Using relaxation exercises to deal with stress
Correct Answer: A
Rationale: Daily heavy alcohol consumption poses significant health risks (liver disease, cardiovascular issues), making it the highest priority for lifestyle change.
A patient has suffered a left CVA and has developed severe hemiparesis resulting in a loss of mobility. The nurse notices on assessment that an area over the patient's left elbow appears as non-blanchable erythema and the skin is intact. The nurse should score the patient as having which of the following?
- A. Stage I pressure ulcer
- B. Stage II pressure ulcer
- C. Stage III pressure ulcer
- D. Stage IV pressure ulcer
Correct Answer: A
Rationale: Erythema with the skin intact can indicate a Stage I pressure ulcer.
The teaching plan for a postpartum client who is about to be discharged should include which of the following instructions?
- A. It is normal for your breasts to be tender. You should call the physician if you also have redness and fatigue.
- B. Because your baby was delivered vaginally, you might have to urinate more frequently.
- C. It is normal to run a low-grade temperature for a few days. If it is higher than 100°F, call your physician.
- D. Be sure to call your physician if your vaginal discharge becomes bright red.
Correct Answer: D
Rationale: The vaginal discharge after birth is called lochia, and it changes from red (rubra) to serosa (clear) on the third postpartum day. If it returns to red or contains clots, it could signal impending hemorrhage or infection and the physician should be notified.
Tricyclics (Antidepressants) sometimes have which of the following adverse effects on patients that have a diagnosis of depression?
- A. Shortness of breath
- B. Fainting
- C. Large Intestine ulcers
- D. Distal muscular weakness
Correct Answer: B
Rationale: Fainting and hypotension can be caused by Tricyclics.