the client is npo and is receiving total parenteral nutrition tpn via a subclavian line which precautions should the nurse implement select one that d

HESI RN

HESI Leadership and Management

1. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.

A. Place the solution on an IV pump at the prescribed rate.
B. Monitor blood glucose every twelve (12) hours.
C. Weigh the client weekly, first thing in the morning.
D. Change the IV tubing every three (3) days.

Correct answer: D

Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.

2. Which advice is most beneficial for a new nurse manager?

A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
B. Keep in mind that it may take 6 months to feel at ease in a new role.
C. Begin by mentoring other novice nurse managers.
D. Participate in substantial personal growth endeavors.

Correct answer: B

Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.

3. A client with diabetes mellitus is scheduled for surgery. The nurse should prioritize which of the following preoperative actions?

A. Administer a full dose of insulin before surgery
B. Hold all oral hypoglycemic agents the day before surgery
C. Monitor blood glucose levels closely before surgery
D. Instruct the client to avoid all fluids the morning of surgery

Correct answer: C

Rationale: Monitoring blood glucose levels closely before surgery is the priority for a client with diabetes mellitus. This allows for early detection of any abnormalities and helps prevent hypo- or hyperglycemia complications that can arise during the perioperative period. Option A is incorrect because insulin dosing should be individualized based on the client's current blood glucose levels and the surgical plan. Option B is incorrect as abruptly holding oral hypoglycemic agents can lead to uncontrolled blood glucose levels. Option D is incorrect as adequate fluid intake is important for the client's hydration status and overall well-being before surgery.

4. A client with DM is scheduled to have surgery. The nurse should plan to:

A. Give the client a regular diet as ordered.
B. Hold the client's insulin on the morning of surgery.
C. Monitor the client's blood glucose level closely during the perioperative period.
D. Have the client stop taking insulin 48 hours before surgery.

Correct answer: C

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. This is essential to ensure that the client's blood glucose levels remain within the target range and to prevent complications such as hypo- or hyperglycemia. Choices A, B, and D are incorrect because giving a regular diet as ordered, holding insulin on the morning of surgery, or stopping insulin 48 hours before surgery can lead to uncontrolled blood glucose levels, posing risks to the client's safety during the surgical procedure.

5. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?

A. Decreased heart rate
B. Increased weight
C. Increased energy levels
D. Decreased appetite

Correct answer: C

Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.