CRNI Parenteral Nutrition Administration 2

Question 1

What is the maximum recommended rate for initiating total parenteral nutrition in an adult patient?

Accepted Answer

25-50% of goal rate for the first 24 hours

Answer

TPN should be initiated at 25-50% of the goal rate and advanced gradually over 24-48 hours to prevent metabolic complications including refeeding syndrome.

Question 2

Which filter size is required for 3-in-1 (total nutrient admixture) parenteral nutrition containing lipids?

Accepted Answer

1.2-micron filter

Answer

A 1.2-micron filter is required for 3-in-1 TNA solutions because lipid emulsion particles (0.4-0.5 microns) cannot pass through a 0.22-micron filter.

Question 3

A patient's TPN is abruptly discontinued. What is the immediate nursing concern?

Accepted Answer

Rebound hypoglycemia

Answer

Abrupt TPN discontinuation can cause rebound hypoglycemia because the pancreas continues producing elevated insulin levels in response to the sudden drop in glucose infusion.

Question 4

What electrolyte must be closely monitored during the first 72 hours of TPN initiation in a malnourished patient?

Accepted Answer

Phosphorus

Answer

Phosphorus is the most critically affected electrolyte in refeeding syndrome, as insulin-driven cellular uptake can cause severe hypophosphatemia leading to respiratory and cardiac failure.

Question 5

Why must parenteral nutrition solutions be administered through a dedicated lumen?

Accepted Answer

To prevent contamination, incompatibilities, and interruptions that affect glucose delivery

Answer

A dedicated lumen prevents microbial contamination from multiple access points, drug incompatibilities, and infusion interruptions that could cause blood glucose instability.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Parenteral Nutrition Administration 2