a nurse is caring for a client who is receiving total parenteral nutrition tpn the pharmacy is delayed in supplying the clients next container of tpn
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1. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

2. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

3. You are to measure the client's initial blood pressure reading by doing all of the following EXCEPT:

Correct answer: B

Rationale: When measuring blood pressure, it is crucial to follow specific steps to obtain accurate readings. Taking the blood pressure on both arms for comparison helps assess any variations. Pumping the cuff to around 50 mmHg above the point of pulse obliteration ensures accurate measurements. Observing procedures for infection control is vital to prevent the spread of infections. Listening to and identifying the phases of Korotkoff sounds are associated with auscultatory blood pressure measurements, not the initial blood pressure reading process.

4. What is the first thing you should do before sharing information with a patient?

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

5. How many calories are contained in a food that has 15 grams of carbohydrates, 4 grams of protein, and 10 grams of fat?

Correct answer: C

Rationale: To calculate the total calories in a food item, you can use the following conversions: every 1 gram of carbohydrate provides 4 calories, 1 gram of protein provides 4 calories, and 1 gram of fat provides 9 calories. Therefore, for this food item, multiply 15 grams of carbohydrates by 4 calories/gram, 4 grams of protein by 4 calories/gram, and 10 grams of fat by 9 calories/gram. The calculation would be (15 * 4) + (4 * 4) + (10 * 9) = 60 + 16 + 90 = 166 calories. Choice A (106) is incorrect because it does not consider the calories from fat. Choice B (124) is incorrect as it underestimates the calories by not including all macronutrients. Choice D (202) is incorrect as it overestimates the calories by adding up the values incorrectly.

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