Wk. 4 - Administering Parenteral Nutrition Practice Questions

Which patient is the best candidate for parenteral nutrition? a) A patient with esophageal cancer tolerating tube feeds b) A patient with ischemic bowel after mesenteric occlusion c) A patient with anorexia nervosa who refuses meals d) A patient with mild gastritis

B

True or False: PN is indicated when the GI tract is functional but the patient refuses to eat.

False

Which conditions are indications for PN? (Select All That Apply): a) Severe Crohn’s exacerbation with malabsorption b) Prolonged ileus after abdominal surgery c) Radiation enteritis d) Mild peptic ulcer disease e) Short bowel syndrome

A,B,C,E

A patient with severe necrotizing pancreatitis is ordered NPO for bowel rest. Which therapy is most appropriate? a) Oral nutrition supplements b) Enteral tube feeding c) Parenteral nutrition d) Clear liquid diet

C

A patient with a high-grade bowel obstruction is receiving PN. The rationale for PN in this case is: a) To stimulate peristalsis b) To bypass a nonfunctional GI tract c) To enhance digestion d) To provide low-residue nutrition

B

What is the primary source of calories in PN solutions? a) Amino acids b) Dextrose c) Lipids d) Electrolytes

B

Which components are found in standard PN solutions? (Select All That Apply): a) Carbohydrates as dextrose b) Amino acids c) Lipids d) Vitamins and trace elements e) Folic acid only

A,B,C,D

True or False: Lipids in PN are made from soybean/safflower oil with egg phospholipids.

True

Which macronutrient in PN is most closely monitored in patients with hypertriglyceridemia? a) Amino acids b) Dextrose c) Lipids d) Electrolytes

C

Which electrolyte abnormality is most concerning in refeeding syndrome? a) Hypercalcemia b) Hypophosphatemia c) Hypernatremia d) Hypermagnesemia

B

Which type of line is required for PN with >15% dextrose? (Select All That Apply): a) Peripheral IV line b) Central venous catheter c) Midline catheter d) PICC or central line

B,D

Which are correct nursing practices for PN administration? a) Use an infusion pump b) Strict aseptic catheter care c) Hang lipids alone for max 24 hours d) Do not piggyback other meds into PN line unless compatible e) Inspect PN bags for precipitates

A,B,D,E

How long can PN (without lipids) hang before requiring a new bag? a) 8 hours b) 12 hours c) 24 hours d) 48 hours

C

True or False: PN solutions should be refrigerated during infusion to prevent bacterial growth.

False

What is the purpose of an in-line IV filter during PN infusion? a) To prevent lipid breakdown b) To remove particulate matter and precipitates c) To sterilize the solution d) To control infusion rate

B

What is the most important action before starting PN infusion? a) Warm solution in microwave b) Confirm correct solution with two nurses c) Flush catheter with heparin d) Draw baseline CBC

B

What is the most common metabolic complication of PN? a) Hypocalcemia b) Hypoglycemia c) Hyperglycemia d) Hypertriglyceridemia

C

Which electrolyte abnormalities are associated with refeeding syndrome? (Select All That Apply) a) Hypophosphatemia b) Hypokalemia c) Hypomagnesemia d) Hypernatremia e) Hypercalcemia

A,B,C

True or False: Long-term PN use may cause PN-associated liver disease.

True

Which complication is unique to lipid infusion? a) Refeeding syndrome b) Hyperglycemia c) Fat overload syndrome d) Thrombophlebitis

C

A patient suddenly develops chest pain and dyspnea after central line removal. The nurse suspects: a) Pneumothorax b) Air embolism c) Catheter occlusion d) Thrombophlebitis

B

Venous access complications of PN include (Select All That Apply): a) CLABSI b) Thrombosis c) Air embolism d) Dysrhythmias on insertion e) Seizures

A,B,C,D

A patient receiving PN is found to have new jaundice, elevated triglycerides, and hepatomegaly. Which complication is most likely? a) Refeeding syndrome b) PN-associated liver disease c) Fat overload syndrome d) Sepsis

B

True or False: Hypertriglyceridemia is a risk in patients receiving lipid emulsions as part of PN.

True

How often should blood glucose be checked initially for patients on PN? a) Once daily b) Every 6 hours c) Every 12 hours d) Every 2 hours

B

Why should PN not be discontinued abruptly? a) Risk of rebound hypoglycemia b) Risk of rebound hyperkalemia c) Risk of infection d) Risk of hypertriglyceridemia

A

Appropriate assessments for patients on PN include (Select All That Apply): a) Daily weights b) Strict I&O c) Monitor triglycerides d) Assess catheter site for infection e) Monthly CBC

A,B,C,D

Which is the nurse’s first action if air embolism is suspected during central line removal? a) Notify the provider immediately b) Place patient on left side in Trendelenburg position c) Start chest compressions d) Administer IV calcium

B

True or False: If refeeding syndrome is suspected, electrolyte abnormalities should be corrected before continuing PN.

True

Nursing interventions to prevent PN complications include (Select All That Apply): a) Taper PN when discontinuing b) Seizure precautions in high-risk patients c) Use strict central line asepsis d) Avoid monitoring labs daily e) Educate patients about signs of infection

A,B,C,E