A client is prescribed total parenteral nutrition (TPN). Which education should the nurse provide?

Correct Answer: C

Rationale: Total parenteral nutrition (TPN) for long-term use requires a central line because it delivers high-concentration nutrients directly into large veins, like the subclavian, to avoid peripheral vein damage and ensure effective nutrient distribution. Clients can manage TPN at home with proper training, debunking the idea they must stay hospitalized until it's discontinued. It's also administered continuously or cyclically via an infusion pump for precise control, not on a twice-weekly outpatient schedule, which aligns with parenteral nutrition's complexity. The pump ensures steady delivery, critical for metabolic stability, while TPN's comprehensive nutritional support meets all dietary needs intravenously. This central line approach is standard for prolonged therapy, distinguishing it from short-term peripheral options, and supports home management, enhancing quality of life while addressing nutritional deficits effectively.

Correct Answer: A

Rationale: The therapeutic and adverse effects associated with these drugs are related to their adrenergic-receptor-site specificity; that is, the ability to react with specific adrenergic receptor sites without activating them, thus preventing the typical manifestations of sympathetic nervous system (SNS) activation. By occupying the adrenergic receptor site, they prevent norepinephrine released from the nerve terminal or from the adrenal medulla from activating the receptor, thus blocking the SNS effects. The nurse should understand the mechanism of action of adrenergic blocking agents to ensure safe and effective administration.

Correct Answer: D

Rationale: Acetaminophen is not an opioid or NSAID. While it is commonly used to relieve pain and reduce fever, acetaminophen works differently from opioids and NSAIDs. Acetaminophen is believed to reduce pain by inhibiting the production of prostaglandins in the brain, whereas opioids work by binding to opioid receptors in the central nervous system, and NSAIDs work by inhibiting the production of prostaglandins in the peripheral tissues.

Correct Answer: B

Rationale: When a patient begins to experience chest pain, especially during physical activity like mowing the lawn on a hot day, the first action should be to stop the activity immediately and sit or lie down. This is because chest pain could be a sign of a serious issue like a heart attack. By stopping the physical activity and resting, the patient can help reduce the workload on the heart and potentially prevent further strain or damage. It is important to take chest pain seriously and seek medical attention promptly.

Correct Answer: B

Rationale: Hydroxychloroquine can cause retinal toxicity, leading to vision loss. Regular ophthalmologic examinations are essential to detect early signs of toxicity. While dental, pulmonary, and endocrine health are important, they are not directly related to hydroxychloroquine's side effects. Monitoring for retinal changes is critical to ensure the safe use of this medication.