Which assessment should the nurse prioritize for a client receiving total parenteral nutrition (TPN)?

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Question 1 of 5

Which assessment should the nurse prioritize for a client receiving total parenteral nutrition (TPN)?

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

Question 2 of 5

The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse?

Correct Answer: B

Rationale: Herbals (e.g., St. John's wort) transfer to breast milk, risking infant effects (e.g., sedation), so avoiding them is safest, per pharmacokinetics. Labels lack consistent breastfeeding data. ‘Natural' doesn't mean safe-some are toxic. Timing doesn't eliminate transfer. Transfer risk advises caution, protecting the baby.

Question 3 of 5

What is the priority outcome for a 6-year-old patient who had been started on methylphenidate (Ritalin)?

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

A mother brings her 4-year-old son to the emergency department after discovering him eating her iron supplement. Which of the following should be administered to chelate the excess iron in his body?

Correct Answer: B

Rationale: Iron overdose in a child requires a specific chelator. Deferoxamine binds ferric iron, forming ferrioxamine, excreted renally. EDTA chelates calcium and lead, not iron-specific. Dimercaprol treats heavy metals like arsenic, not iron. Penicillamine is for copper (Wilson's disease). Succimer (E) targets lead. Deferoxamine's high affinity for iron makes it standard for acute toxicity, preventing organ damage (e.g., liver, heart), critical in this pediatric emergency.

Question 5 of 5

A 44-year-old man with acute lymphocytic leukemia is undergoing a multiagent chemotherapy protocol. Agents used include methotrexate. The cycle of medication will last 6 weeks. Which of the following tissues is most likely to experience toxic effects as a result of this therapy?

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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