Complex care NCLEX Exam test preparation
Questions and Must have marking scheme
Updated version 2024/2025
Severe nutritionally deficient conditions such as immunodeficiency syndrome, cancer, burn
injuries, malnutrition, chemo (INITIATION OF ENTERAL NUTRITION IS INITIATED FIRST)
If the bag of intravenous solution (the TPN) is empty and the nurse is waiting for the delivery of
a new bag of solution from the pharmacy, a _____________ in water solution should be infused
at the prescribed rate to prevent hypoglycemia; the prescribed solution should be obtained as
soon as possible. - correct answer 10% dextrose
The delivery of hypertonic solutions into peripheral veins can cause _____, _____, _____
Monitor closely for these complications. - correct answer sclerosis, phlebitis, or swelling.
Carbohydrates typically provide ____ to ___% of calories - correct answer 60-70%
Amino acids provide ___ to ___ % of the total energy needs - correct answer 15-20%
Lipids provide up to ___ of calorie need s - correct answer 30%
Fat emulsions are _____ and can be administered through a PIV. The solution can be
administered through a separate IV line below the filter of the main IV administration set by a
________, or as an admixture to the PN solution (3 in 1 admixture) - correct answer isotonic
Y connector
Most fat emulsions are prepared from ______ or ______ oil with EGG YOLK. The primary
components are linoleic, oleic, palmitic, linolenic, and stearic acids. - correct answer soybean
Safflower oil
,ASSESS FOR EGG ALLERGIES
DM CLIENTS may benefit from receiving a larger % of their PN from _______, which helps
control blood glucose levels. - correct answer lipids
Additives should ____ be put in the fat emulsion - correct answer NOT
Fat emulsions are usually administered slowly at __ml/min. Monitor VS every ___ min, and
observe for adverse reactions for the first ____ min. If no adverse reaction occurs, adjust the
flow rate to the prescribed rate. - correct answer 1
10min
30min
Monitor serum lipids ___ hours after d/c the infusion - correct answer 4 hours
Sx of adverse reactions to lipids - correct answer ▪ Chest and back pain
▪ Chills
▪ Cyanosis
▪ Diaphoresis
▪ Dyspnea
▪ Fever
▪ Flushing
▪ Headache
▪ Nausea and vomiting
▪ Pressure over the eyes
▪Thrombophlebitis
▪ Vertigo
Some PN solutions may contain _____ or ______ - correct answer insulin
, Heparin
Intermittent or cyclic PN is generally administered _____. It is important to monitor _____
because of the risk for ______ - correct answer overnight
Blood sugar
Hypoglycemia
Before discontinuing PN, evaluation by a _______ is done. - correct answer nutritionist.
If discontinuation of PN is prescribed, gradually decrease the flow rate for ___ or _____ hrs
while increasing oral intake (this assists in preventing hypoglycemia). - correct answer 1 to 2
hours
With severely malnourished clients on PN, monitor for "refeeding syndrome" (a rapid drop in
_____, _____, and _____ serum levels) - correct answer potassium, magnesium, and
phosphate
Monitor for shallow respirations, confusion, weakness, bleeding tendencies, and seizures. If
noted, the PHCP is notified immediately.
Abnormal liver function values may indicate intolerance to or an excess of fat emulsion or
problems with metabolism with glucose and protein - correct answer <-
Abnormal ______ function tests may indicate an excess of amino acids. - correct answer renal
PN solutions should be stored under refrigeration and administered within __ hours from the
time they are prepared (remove from refrigerator __ to ____ hour/s before use) - correct
answer 24
0.5 to 1
Questions and Must have marking scheme
Updated version 2024/2025
Severe nutritionally deficient conditions such as immunodeficiency syndrome, cancer, burn
injuries, malnutrition, chemo (INITIATION OF ENTERAL NUTRITION IS INITIATED FIRST)
If the bag of intravenous solution (the TPN) is empty and the nurse is waiting for the delivery of
a new bag of solution from the pharmacy, a _____________ in water solution should be infused
at the prescribed rate to prevent hypoglycemia; the prescribed solution should be obtained as
soon as possible. - correct answer 10% dextrose
The delivery of hypertonic solutions into peripheral veins can cause _____, _____, _____
Monitor closely for these complications. - correct answer sclerosis, phlebitis, or swelling.
Carbohydrates typically provide ____ to ___% of calories - correct answer 60-70%
Amino acids provide ___ to ___ % of the total energy needs - correct answer 15-20%
Lipids provide up to ___ of calorie need s - correct answer 30%
Fat emulsions are _____ and can be administered through a PIV. The solution can be
administered through a separate IV line below the filter of the main IV administration set by a
________, or as an admixture to the PN solution (3 in 1 admixture) - correct answer isotonic
Y connector
Most fat emulsions are prepared from ______ or ______ oil with EGG YOLK. The primary
components are linoleic, oleic, palmitic, linolenic, and stearic acids. - correct answer soybean
Safflower oil
,ASSESS FOR EGG ALLERGIES
DM CLIENTS may benefit from receiving a larger % of their PN from _______, which helps
control blood glucose levels. - correct answer lipids
Additives should ____ be put in the fat emulsion - correct answer NOT
Fat emulsions are usually administered slowly at __ml/min. Monitor VS every ___ min, and
observe for adverse reactions for the first ____ min. If no adverse reaction occurs, adjust the
flow rate to the prescribed rate. - correct answer 1
10min
30min
Monitor serum lipids ___ hours after d/c the infusion - correct answer 4 hours
Sx of adverse reactions to lipids - correct answer ▪ Chest and back pain
▪ Chills
▪ Cyanosis
▪ Diaphoresis
▪ Dyspnea
▪ Fever
▪ Flushing
▪ Headache
▪ Nausea and vomiting
▪ Pressure over the eyes
▪Thrombophlebitis
▪ Vertigo
Some PN solutions may contain _____ or ______ - correct answer insulin
, Heparin
Intermittent or cyclic PN is generally administered _____. It is important to monitor _____
because of the risk for ______ - correct answer overnight
Blood sugar
Hypoglycemia
Before discontinuing PN, evaluation by a _______ is done. - correct answer nutritionist.
If discontinuation of PN is prescribed, gradually decrease the flow rate for ___ or _____ hrs
while increasing oral intake (this assists in preventing hypoglycemia). - correct answer 1 to 2
hours
With severely malnourished clients on PN, monitor for "refeeding syndrome" (a rapid drop in
_____, _____, and _____ serum levels) - correct answer potassium, magnesium, and
phosphate
Monitor for shallow respirations, confusion, weakness, bleeding tendencies, and seizures. If
noted, the PHCP is notified immediately.
Abnormal liver function values may indicate intolerance to or an excess of fat emulsion or
problems with metabolism with glucose and protein - correct answer <-
Abnormal ______ function tests may indicate an excess of amino acids. - correct answer renal
PN solutions should be stored under refrigeration and administered within __ hours from the
time they are prepared (remove from refrigerator __ to ____ hour/s before use) - correct
answer 24
0.5 to 1
