CRNI Parenteral Nutrition Administration 5

Question 1

Which assessment finding in a patient receiving PN would indicate the EARLIEST sign of catheter-related bloodstream infection (CRBSI)?

Accepted Answer

Unexplained fever and chills

Answer

Unexplained fever and chills without another identifiable source is the earliest and most common sign of CRBSI in patients receiving PN.

Question 2

A provider orders PN to be started immediately, but the pharmacy-prepared bag is not yet available. The nurse should administer:

Accepted Answer

Dextrose 10% in water (D10W) at the prescribed PN rate

Answer

D10W is the appropriate bridge solution when PN is unavailable because it prevents hypoglycemia in patients who have been on PN and maintains carbohydrate substrate.

Question 3

When weaning a patient off long-term PN, the nurse anticipates the rate should be:

Accepted Answer

Tapered gradually over several hours to prevent hypoglycemia

Answer

PN should be tapered gradually (typically over 1-2 hours) rather than stopped abruptly to prevent rebound hypoglycemia from persistent insulin secretion.

Question 4

A patient on long-term home PN develops elevated AST, ALT, and alkaline phosphatase. The nurse recognizes this as:

Accepted Answer

PN-associated liver disease (PNALD)

Answer

PN-associated liver disease (PNALD) is a well-recognized complication of long-term PN, presenting with elevated liver enzymes and potentially progressing to steatosis or cholestasis.

Question 5

Which nursing intervention BEST prevents catheter occlusion in a patient receiving PN via a central venous catheter?

Accepted Answer

Flushing the catheter with preservative-free normal saline before and after PN infusion

Answer

Flushing with preservative-free normal saline before and after PN helps clear the catheter of residue and prevents fibrin and lipid buildup that can cause occlusion.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Parenteral Nutrition Administration 5