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    Ati rn comprehensive predictor 2023 proctored exam

    A charge nurse is monitoring a newly licensed nurse who is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following statements by the newly licensed nurse indicates an understanding of the procedure?

    Explanation & Rationale

    A. "I will monitor the client's blood glucose level every 8 hours.": Blood glucose should be monitored more frequently, typically every 4–6 hours, because TPN is high in dextrose and can cause rapid hyperglycemia or hypoglycemia if interrupted. Monitoring every 8 hours does not provide adequate safety surveillance. B. "I will increase the rate of the TPN infusion to ensure the correct amount is given.": Rapidly increasing the infusion rate can cause hyperglycemia, fluid overload, and electrolyte imbalances. TPN should always be titrated according to the provider’s prescription and protocols to avoid complications. C. "I will obtain the client's weight every other day.": Clients receiving TPN should be weighed daily to accurately monitor fluid status, nutritional progress, and detect early signs of fluid overload or dehydration. Weight assessment every other day is insufficient. D. "I will hang a new bag of TPN and IV tubing every 24 hours.": Changing the TPN solution and tubing every 24 hours is a critical infection prevention measure. TPN is a high-glucose solution that supports bacterial growth, so adhering to this schedule reduces the risk of catheter-related bloodstream infections.

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