Nokea
The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?
- A. TPN is usually indicated for clients needing short term (less than 3 weeks) nutritional support, whereas PPN is for long term maintenance
- B. A client needing more than 3000 calories would receive PPN, whereas TPN is given to those requiring less than 3000 calories
- C. TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake
- D. TPN is given to those who need to augment oral feeding, whereas PPN is used for those who are nothing by mouth
Correct Answer: C
Rationale: The statement that is true about TPN and peripheral parenteral nutrition (PPN) is that TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake. This is because TPN is a hypertonic solution that can cause fluid overload if given in large volumes, so it's typically reserved for patients who have fluid restrictions. On the other hand, PPN is a less concentrated solution that can be safely administered to patients without fluid restrictions.
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A female client with lymphedema expresses her anxiety about the abnormal enlargement of an arm. Which of the ff suggestions should a nurse give to support the clients self image?
- A. Place the arm in the sling
- B. Apply cold soaks to the affected arm
- C. Introduce variations in styles of clothing
- D. Tie a tight bandage to the arm
Correct Answer: C
Rationale: Introducing variations in styles of clothing can help the client feel more comfortable and confident despite the abnormal enlargement of her arm due to lymphedema. By wearing different styles of clothing that accommodate the affected arm, the client can still express her personal style and feel good about her appearance. This approach can help improve the client's self-image and self-esteem, supporting her emotionally as she copes with the condition. Placing the arm in a sling, applying cold soaks, or tying a tight bandage are not appropriate suggestions for addressing the client's anxiety and self-image concerns in this situation.
Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture?
- A. Negative scarf sign
- B. Asymmetric Moro reflex
- C. Swelling of fingers on affected side
- D. Paralysis of affected extremity and muscles
Correct Answer: C
Rationale: A newborn with a clavicle fracture may present with swelling of the fingers on the affected side. This is due to the injury disrupting the nerves and blood vessels that supply the arm, leading to edema and swelling in the fingers. The other signs mentioned in the options are not typically associated with a clavicle fracture. A negative scarf sign relates to positioning of the arm and is not specific to a clavicle fracture. Asymmetric Moro reflex can be a normal finding in newborns and not indicative of a fracture. Paralysis of the affected extremity and muscles would be more suggestive of a nerve injury rather than a clavicle fracture.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.
How many liters per minute of oxygen should be administered to the patient with emphysema?
- A. 2 L/min
- B. 10 L/min
- C. 6 L/min
- D. 95 L/min
Correct Answer: C
Rationale: Oxygen therapy for patients with emphysema aims to maintain adequate oxygen levels in the blood while avoiding toxic levels of oxygen. The recommended flow rate for oxygen administration in patients with emphysema is typically 1-3 liters per minute. Increasing the flow rate above this range may lead to oxygen toxicity in these patients. Therefore, a safe and appropriate oxygen flow rate for a patient with emphysema would be around 6 L/min, making option C, 6 L/min, the correct choice from the provided options.
Which of the ff is the potential complication the nurse should monitor for when caring for a client with acute respiratory distress syndrome?
- A. Chest wall bulging
- B. Renal failure
- C. Difficulty swallowing
- D. Orthopnea CARING FOR CLIENTS WITH INFECTIOUS AND INFLAMMATORY DISORDERS OF THE HEART AND BLOOD VESSELS
Correct Answer: B
Rationale: Acute respiratory distress syndrome (ARDS) is a serious condition that can lead to various complications, including renal failure. When a client is experiencing ARDS, the lungs become severely inflamed and filled with fluid, which can lead to decreased oxygen levels in the blood. This decrease in oxygen can place a significant strain on the kidneys, potentially resulting in renal failure. Therefore, it is crucial for nurses to monitor the client for signs and symptoms of renal failure, such as changes in urine output, fluid imbalance, electrolyte abnormalities, and altered mental status. Timely detection and management of renal complications in clients with ARDS are essential to prevent further deterioration of the client's condition.