ESTUDYR
CASE STUDY TOTAL PARENTERAL NUTRITION
(VIDEO CASE STUDY)
⃣ When administering a refrigerated TPN solution, the nurse should:
A) Infuse it immediately to preserve sterility
B) Warm it on a heating pad to body temperature
C) ✅Remove it from the refrigerator hour prior to infusion
D) Spike the bag and let it hang at room temperature for 5 minutes
Rationale: Allowing TPN to reach room temperature for about an hour prevents patient discomfort from
cold infusate and reduces risk of hyperthermia from rapid warming.
⃣ Discharge teaching for home PPN via a PICC should include:
A) Store feeding equipment on the bedside table for easy access
B) Flush the PICC line only when infusions are running
C) Change dressings every 5–7 days only
D) ✅Place feeding equipment out of the client’s view when not in use
Rationale: Hiding equipment helps patients maintain body image and psychosocial well-being by
minimizing reminders of their dependency on nutritional support.
⃣ A client’s new TPN bag is delayed. The nurse should hang which solution until TPN arrives?
A) Dextrose 5% in water
B) Lactated Ringer’s solution
C) Normal saline
D) ✅Dextrose 10% in water
Rationale: A hypertonic dextrose solution prevents rebound hypoglycemia by matching the
carbohydrate load of TPN when it’s briefly unavailable.
⃣ To reduce infection risk during TPN administration, the nurse should plan to:
A) Change the TPN solution bag every 12 hours
B) Flush the line with heparin after each infusion
, ESTUDYR
C) Refrigerate the unused tubing between uses
D) ✅Change the client’s IV catheter tubing every hours
Rationale: Frequent tubing changes (every 24 hr) minimize bacterial/fungal colonization in the
hyper-osmolar, nutrient-rich lines.
⃣ Reviewing labs for a client on TPN, which value indicates an adverse effect?
A) Sodium 138 mEq/L
B) Potassium 4.2 mEq/L
C) BUN 18 mg/dL
D) ✅Glucose 9 mg/dL
Rationale: Hyperglycemia (blood glucose > 100 mg/dL) is a common TPN complication due to high
dextrose content and requires insulin management.
⃣ Before starting TPN, the nurse should verify:
A) The client has fasted for 8 hours
B) The client’s hemoglobin is > 12 g/dL
C) The TPN contains at least 25% dextrose
D) ✅The prescription includes an order for daily electrolyte labs
Rationale: Daily monitoring of electrolytes (Na⁺, K⁺, Mg²⁺, PO₄³⁻) is essential to detect shifts and prevent
complications.
⃣ To minimize air embolism risk when discontinuing TPN via central line, the nurse should:
A) Pull the catheter steadily while the client inhales deeply
B) ✅Have the client perform the Valsalva maneuver during removal
C) Place the client in Trendelenburg, then remove on exhalation
D) Flush the line with 10 mL normal saline before removal
Rationale: Valsalva increases intrathoracic pressure, reducing the chance of air entry.
⃣ A sudden drop in TPN infusion rate may cause:
A) Hyperglycemia
B) ✅Hypoglycemia
C) Hypernatremia
D) Hyperkalemia
CASE STUDY TOTAL PARENTERAL NUTRITION
(VIDEO CASE STUDY)
⃣ When administering a refrigerated TPN solution, the nurse should:
A) Infuse it immediately to preserve sterility
B) Warm it on a heating pad to body temperature
C) ✅Remove it from the refrigerator hour prior to infusion
D) Spike the bag and let it hang at room temperature for 5 minutes
Rationale: Allowing TPN to reach room temperature for about an hour prevents patient discomfort from
cold infusate and reduces risk of hyperthermia from rapid warming.
⃣ Discharge teaching for home PPN via a PICC should include:
A) Store feeding equipment on the bedside table for easy access
B) Flush the PICC line only when infusions are running
C) Change dressings every 5–7 days only
D) ✅Place feeding equipment out of the client’s view when not in use
Rationale: Hiding equipment helps patients maintain body image and psychosocial well-being by
minimizing reminders of their dependency on nutritional support.
⃣ A client’s new TPN bag is delayed. The nurse should hang which solution until TPN arrives?
A) Dextrose 5% in water
B) Lactated Ringer’s solution
C) Normal saline
D) ✅Dextrose 10% in water
Rationale: A hypertonic dextrose solution prevents rebound hypoglycemia by matching the
carbohydrate load of TPN when it’s briefly unavailable.
⃣ To reduce infection risk during TPN administration, the nurse should plan to:
A) Change the TPN solution bag every 12 hours
B) Flush the line with heparin after each infusion
, ESTUDYR
C) Refrigerate the unused tubing between uses
D) ✅Change the client’s IV catheter tubing every hours
Rationale: Frequent tubing changes (every 24 hr) minimize bacterial/fungal colonization in the
hyper-osmolar, nutrient-rich lines.
⃣ Reviewing labs for a client on TPN, which value indicates an adverse effect?
A) Sodium 138 mEq/L
B) Potassium 4.2 mEq/L
C) BUN 18 mg/dL
D) ✅Glucose 9 mg/dL
Rationale: Hyperglycemia (blood glucose > 100 mg/dL) is a common TPN complication due to high
dextrose content and requires insulin management.
⃣ Before starting TPN, the nurse should verify:
A) The client has fasted for 8 hours
B) The client’s hemoglobin is > 12 g/dL
C) The TPN contains at least 25% dextrose
D) ✅The prescription includes an order for daily electrolyte labs
Rationale: Daily monitoring of electrolytes (Na⁺, K⁺, Mg²⁺, PO₄³⁻) is essential to detect shifts and prevent
complications.
⃣ To minimize air embolism risk when discontinuing TPN via central line, the nurse should:
A) Pull the catheter steadily while the client inhales deeply
B) ✅Have the client perform the Valsalva maneuver during removal
C) Place the client in Trendelenburg, then remove on exhalation
D) Flush the line with 10 mL normal saline before removal
Rationale: Valsalva increases intrathoracic pressure, reducing the chance of air entry.
⃣ A sudden drop in TPN infusion rate may cause:
A) Hyperglycemia
B) ✅Hypoglycemia
C) Hypernatremia
D) Hyperkalemia
