PN | Questions with 100% Verified Answers | Latest Update
2026/2027
Question: mL of ILE
Answer: 1 mL of 20% ILE = 2 kcal
Question: EFAD
Answer: Failure to provide at least 2% to 4% of the total caloric intake as linoleic acid and
0.25% to
0.5% of total caloric intake as alpha-linolenic acid may lead to a deficiency of these two
fatty acids
A triene to tetraene ratio >0.2
Question: preventing EFAD
Answer: 500 ml of 10% soy-based ILE twice a week or 250 ml of 20% soy-based ILE are
administered twice a week
A total of 100 g of 20% soy ILE per week is the minimum amount needed to prevent EFAD
Greater amount needs in alternative oil based ILE such as olive oil/fish oil/MCT
Question: Metabolic acidosis/tissue catabolism/pseudohyperkalemia in
PN
Answer: results in an extracellular shift of potassium to maintain electroneutrality
For every 0.1 decrease in pH, potassium will increase by 0.6 mEq per liter generally.
may need to adjust potassium content in PN
Question: TNA (total nutrient admixture)
Answer: creaming: A translucent band at the surface of the emulsion separate from the
remaining
TNA dispersion
Although the lipid particles in the cream layer are destabilized, their individual droplet
identities are generally preserved.
particles can be redispersed with gentle agitation and used safely
Question: TNA cracking/emulsion destabalization
Answer: small lipid particles coalesce to form large droplets ranging in size from 5-50 or more
microns
yellow-brown oil droplets near TNA surface or continuous layer at surface,
marbling/streaking of the oil throughout the TNA
Question: Mixed oil ILE
Answer: provides a more balanced mixture of fatty acids compared to the 100% soy oil-based
ILE
historically used
lower inflammatory profile is due to an improved omega-6 to omega-3 ratio. Decreased
arachidonic acid delivery accompanied with increased eicosapentaenoic acid and
doxahexaenoic acid delivery results in decreased inflammatory eicosanoids
, Question: olive oil rich ILE
Answer: shown to have less effect on immune response, including lymphocytes, natural killer
cells,
and neutrophils
Question: RDA/AI for fat-soluble vitamins given orally vs parenterally
Answer: approx equal
Question: RDA/AI for water-soluble vitamins given orally vs parenterally
Answer: 2-5.5x greater in PN than oral
Question: PN Safety Consensus Recommendations
Answer: label should list PN ingredients in amounts per day for adults and amounts per
kilogram
per day for pediatric and neonatal patients
Amount per day refers to macronutrients in grams per day and micronutrients in mEq,
mmol, mcg, or mg per day.
Question: PN Safety Consensus Recommendations mandatory PN order
Answer: complete patient identifiers,
birth date or age,
allergies,
height and dosing weight in metric units,
diagnosis/diagnoses, indication(s) for PN,
administration route/vascular access device (peripheral versus central),
contact information for prescriber,
date and time order submitted,
administration date and time, volume and infusion rate,
infusion schedule (continuous or cyclic),
and type of formulation (3-in-1 versus 2-in-1 with separate lipid injectable emulsions (ILE)).
Question: PN ingredients ordered as:
Answer: Amounts per day
Electrolytes as complete salt forms full generic name for each ingredient (using the Joint
Commission approved abbreviations and avoiding Institute for Safe Medication Practices
error-prone abbreviations, symbols, and dose designations)
Dose for each macronutrient and electrolyte
Dose for vitamins (including MVI and individual entities)
Dose for trace elements (including multi-components and/or individual entities)
Dose for each non-nutrient medication
Question: Automated compounding device (ACD)
Answer: Compounding with ACDs should lead to improved compounding accuracy,
enforcement
of proper compounding sequence, and reduction in opportunities for human touch
contamination
When an ACD is used, it should deliver all PN ingredients
2026/2027
Question: mL of ILE
Answer: 1 mL of 20% ILE = 2 kcal
Question: EFAD
Answer: Failure to provide at least 2% to 4% of the total caloric intake as linoleic acid and
0.25% to
0.5% of total caloric intake as alpha-linolenic acid may lead to a deficiency of these two
fatty acids
A triene to tetraene ratio >0.2
Question: preventing EFAD
Answer: 500 ml of 10% soy-based ILE twice a week or 250 ml of 20% soy-based ILE are
administered twice a week
A total of 100 g of 20% soy ILE per week is the minimum amount needed to prevent EFAD
Greater amount needs in alternative oil based ILE such as olive oil/fish oil/MCT
Question: Metabolic acidosis/tissue catabolism/pseudohyperkalemia in
PN
Answer: results in an extracellular shift of potassium to maintain electroneutrality
For every 0.1 decrease in pH, potassium will increase by 0.6 mEq per liter generally.
may need to adjust potassium content in PN
Question: TNA (total nutrient admixture)
Answer: creaming: A translucent band at the surface of the emulsion separate from the
remaining
TNA dispersion
Although the lipid particles in the cream layer are destabilized, their individual droplet
identities are generally preserved.
particles can be redispersed with gentle agitation and used safely
Question: TNA cracking/emulsion destabalization
Answer: small lipid particles coalesce to form large droplets ranging in size from 5-50 or more
microns
yellow-brown oil droplets near TNA surface or continuous layer at surface,
marbling/streaking of the oil throughout the TNA
Question: Mixed oil ILE
Answer: provides a more balanced mixture of fatty acids compared to the 100% soy oil-based
ILE
historically used
lower inflammatory profile is due to an improved omega-6 to omega-3 ratio. Decreased
arachidonic acid delivery accompanied with increased eicosapentaenoic acid and
doxahexaenoic acid delivery results in decreased inflammatory eicosanoids
, Question: olive oil rich ILE
Answer: shown to have less effect on immune response, including lymphocytes, natural killer
cells,
and neutrophils
Question: RDA/AI for fat-soluble vitamins given orally vs parenterally
Answer: approx equal
Question: RDA/AI for water-soluble vitamins given orally vs parenterally
Answer: 2-5.5x greater in PN than oral
Question: PN Safety Consensus Recommendations
Answer: label should list PN ingredients in amounts per day for adults and amounts per
kilogram
per day for pediatric and neonatal patients
Amount per day refers to macronutrients in grams per day and micronutrients in mEq,
mmol, mcg, or mg per day.
Question: PN Safety Consensus Recommendations mandatory PN order
Answer: complete patient identifiers,
birth date or age,
allergies,
height and dosing weight in metric units,
diagnosis/diagnoses, indication(s) for PN,
administration route/vascular access device (peripheral versus central),
contact information for prescriber,
date and time order submitted,
administration date and time, volume and infusion rate,
infusion schedule (continuous or cyclic),
and type of formulation (3-in-1 versus 2-in-1 with separate lipid injectable emulsions (ILE)).
Question: PN ingredients ordered as:
Answer: Amounts per day
Electrolytes as complete salt forms full generic name for each ingredient (using the Joint
Commission approved abbreviations and avoiding Institute for Safe Medication Practices
error-prone abbreviations, symbols, and dose designations)
Dose for each macronutrient and electrolyte
Dose for vitamins (including MVI and individual entities)
Dose for trace elements (including multi-components and/or individual entities)
Dose for each non-nutrient medication
Question: Automated compounding device (ACD)
Answer: Compounding with ACDs should lead to improved compounding accuracy,
enforcement
of proper compounding sequence, and reduction in opportunities for human touch
contamination
When an ACD is used, it should deliver all PN ingredients
