Correct Answer: Fluid retention
Rationale: Pioglitazone (a TZD) causes fluid retention and edema, which can trigger or worsen
heart failure. Nurses should monitor for weight gain, swelling, and shortness of breath.
,Correct Answer: Crackles in the lungs
Rationale: Mannitol is an osmotic diuretic that draws fluid into the vascular space to reduce
intraocular or intracranial pressure. This rapid shift can lead to hypervolemia and pulmonary
edema, causing crackles in the lungs.
Calculation:
1. Convert weight to kg:
$$132\text{ lbs} \div 2.2 = 60\text{ kg}$$
, 2. Calculate total dosage (mg):
$$10\text{ mg/kg} \times 60\text{ kg} = 600\text{ mg}$$
3. Calculate volume to administer (mL):
$$600\text{ mg} \div 50\text{ mg/mL} = 12\text{ mL}$$
Correct Answer: 12
Correct Answer: Monitor the client's weight daily.
Rationale: Clients receiving total parenteral nutrition (TPN) are at high risk for fluid overload
and fluid volume shifts. Daily weight measurement is the most accurate indicator of fluid
retention or loss and effectiveness of therapy.
• Why other options are incorrect: Blood glucose must be checked every 4 to 6 hours
(not weekly), TPN rate is determined by provider order/nutritional needs (not titrated to
blood pressure), and TPN must be administered using an electronic infusion pump (never
gravity).
, Correct Answer: "You will receive TPN through a central vein."
Rationale: Total parenteral nutrition (TPN) is a hypertonic solution containing high
concentrations of dextrose and amino acids, requiring administration through a central venous
catheter (such as a PICC or central line) to prevent vein irritation and thrombosis.
• Why other options are incorrect: TPN is indicated for non-functional GI tracts or severe
malnutrition, not high glucose or low platelets. TPN duration depends on nutritional status
and GI recovery, so stating a fixed 6-month timeframe is inaccurate.
Rationale: Pioglitazone (a TZD) causes fluid retention and edema, which can trigger or worsen
heart failure. Nurses should monitor for weight gain, swelling, and shortness of breath.
,Correct Answer: Crackles in the lungs
Rationale: Mannitol is an osmotic diuretic that draws fluid into the vascular space to reduce
intraocular or intracranial pressure. This rapid shift can lead to hypervolemia and pulmonary
edema, causing crackles in the lungs.
Calculation:
1. Convert weight to kg:
$$132\text{ lbs} \div 2.2 = 60\text{ kg}$$
, 2. Calculate total dosage (mg):
$$10\text{ mg/kg} \times 60\text{ kg} = 600\text{ mg}$$
3. Calculate volume to administer (mL):
$$600\text{ mg} \div 50\text{ mg/mL} = 12\text{ mL}$$
Correct Answer: 12
Correct Answer: Monitor the client's weight daily.
Rationale: Clients receiving total parenteral nutrition (TPN) are at high risk for fluid overload
and fluid volume shifts. Daily weight measurement is the most accurate indicator of fluid
retention or loss and effectiveness of therapy.
• Why other options are incorrect: Blood glucose must be checked every 4 to 6 hours
(not weekly), TPN rate is determined by provider order/nutritional needs (not titrated to
blood pressure), and TPN must be administered using an electronic infusion pump (never
gravity).
, Correct Answer: "You will receive TPN through a central vein."
Rationale: Total parenteral nutrition (TPN) is a hypertonic solution containing high
concentrations of dextrose and amino acids, requiring administration through a central venous
catheter (such as a PICC or central line) to prevent vein irritation and thrombosis.
• Why other options are incorrect: TPN is indicated for non-functional GI tracts or severe
malnutrition, not high glucose or low platelets. TPN duration depends on nutritional status
and GI recovery, so stating a fixed 6-month timeframe is inaccurate.
