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Questions 149

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Question 1 of 5

The nurse is infusing total parenteral nutrition (TPN) through a peripherally inserted central catheter. The client's TPN was turned off for 1 hour for an MRI. Which action by the nurse is most appropriate for this client?

Correct Answer: A

Rationale: Notifying the provider ensures proper adjustment of TPN administration, as altering rates or discarding solution can cause metabolic imbalances.

Question 2 of 5

The nurse is caring for a client with dementia who has pulled out three peripheral IVs. Which intervention by the nurse is the best way to manage this client?

Correct Answer: C

Rationale: Wrapping the IV in gauze hides it from view, reducing the likelihood of the client pulling it out, while being less invasive than restraints or threats.

Question 3 of 5

The nurse is assessing a client who is 36 hours postpartum. Which of the following findings would indicate a need for further evaluation?

Correct Answer: D

Rationale: a temperature of 100.4°F may indicate infection, such as endometritis, and requires further evaluation

Question 4 of 5

Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to:

Correct Answer: B

Rationale: Neutropenia increases infection risk, so a private room minimizes exposure to pathogens.

Question 5 of 5

A client is being monitored using a central venous pressure monitor. If the pressure is 2 cm of water, the nurse should:

Correct Answer: B

Rationale: A CVP of 2 cm of water is low, suggesting hypovolemia; slowing the IV infusion prevents fluid overload while addressing the issue.

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