CRNI Parenteral Nutrition Administration Questions and Answers

Question 1

A patient has been receiving continuous parenteral nutrition for three weeks.
The central venous catheter becomes occluded, and the infusion is abruptly stopped.
Which of the following is the nurse's priority assessment?

Accepted Answer

Signs of hypoglycemia, such as diaphoresis and shakiness

Answer

Signs of hypervolemia, such as crackles and edema

Answer

Signs of catheter-related infection, such as fever and chills

Answer

Signs of essential fatty acid deficiency, such as scaly dermatitis

Question 2

A CRNI is preparing to administer a 3-in-1 total nutrient admixture (TNA) containing dextrose, amino acids, and a lipid emulsion. Which in-line filter is required for the safe administration of this solution?

Accepted Answer

A 1.2-micron filter

Answer

A 5-micron filter

Answer

A 0.22-micron filter

Answer

No filter is necessary if a dedicated lumen is used

Question 3

To minimize the risk of refeeding syndrome in a severely malnourished patient starting on parenteral nutrition, which of the following is the most important nursing intervention?

Accepted Answer

Initiate the PN infusion at a slow rate and advance gradually over several days.

Answer

Administer a rapid fluid bolus of 5% Dextrose prior to starting the PN.

Answer

Ensure the initial PN formulation has a high concentration of dextrose.

Answer

Restrict all oral fluid intake for the first 24 hours of PN therapy.

Question 4

A patient is receiving cyclic parenteral nutrition infused over 12 hours nightly. The nurse observes the solution and notes a separated, oily layer on the surface of the admixture. This observation is best described as:

Accepted Answer

Cracking

Answer

Precipitation

Answer

Caramelization

Answer

Sedimentation

Question 5

A patient is scheduled to receive cyclic parenteral nutrition from 2000 to 0800. At 0600, the nurse discovers that 500 mL of the solution is remaining when only 200 mL should be left. What is the most appropriate action for the nurse to take?

Accepted Answer

Continue the infusion at the prescribed rate and document the remaining volume.

Answer

Increase the infusion rate to ensure the full volume is delivered by 0800.

Answer

Stop the infusion at 0800 as scheduled, regardless of the volume remaining.

Answer

Administer an intravenous bolus of 50% dextrose at 0800 to prevent hypoglycemia.

Question 6

Which of the following laboratory values is most critical for the CRNI to monitor in a patient at high risk for refeeding syndrome during the first 72 hours of initiating parenteral nutrition?

Accepted Answer

Serum phosphate

Answer

Serum creatinine

Answer

Hemoglobin and hematocrit

Answer

Blood urea nitrogen (BUN)

A patient has been receiving continuous parenteral nutrition for three weeks.The central venous catheter becomes occluded, and the infusion is abruptly stopped.Which of the following is the nurse's priority assessment?

A patient has been receiving continuous parenteral nutrition for three weeks.
The central venous catheter becomes occluded, and the infusion is abruptly stopped.
Which of the following is the nurse's priority assessment?