NCLEX-RN Practice Questions: Parenteral Nutrition

1. When preparing to change a right subclavian vein TPN bag and tubing, the patient instructions must include:
A. Inhale deeply, hold it, and bear down
B. Breathe normally
C. Exhale slowly and hold it
D. Turning the head to the left

2. Total Parenteral Nutrition (TPN) may not have any medications added to it except:
A. Xanax
B. Phenergan
C. Insulin
D. Demerol

3. A patient receiving parenteral nutrition may have it administered via the following routes except:
A. PICC (Peripherally inserted central catheter) line
B. Peg tube
C. Subclavian line
D. Central Venous Catheter

4. Parenteral nutrition differs from enteral nutrition because:
A. Parenteral nutrition can be given through the digestive system
B. Either type of nutrition can be given through an IV
C. Parenteral nutrition bypasses the digestive system
D. Enteral nutrition bypasses the digestive system

Answers and Rational

1. Correct answer: A
This procedure helps build pressure to keep air from entering the vein.

B. Normal breathing will increase the risk of a dangerous amount of air entering the vein.
C. This procedure will not produce the positive pressure needed to repel outside air.
D. Turning the head is not necessary, though the patient may prefer it.

2. Correct answer: C
Insulin is an acceptable additive for patients who need it with their TPN or PPN. No other additive or component is acceptable through the parenteral line.

A. Xanax cannot be given via a PN line, as it must pass through the digestive system.
B. Phenergan, and many other drugs, can cause precipitation in the TPN formulation.
D Demerol cannot be administered with TPN.

3. Correct answer: B
A peg tube empties formula directly into the stomach to be digested. Parenteral nutrition bypasses the digestive system by administration to the bloodstream.

A. A PICC line is inserted into a peripheral vein, but is long enough to empty into the large veins going directly into the heart.
C. A subclavian line empties directly into the large vein of the heart, reducing risk of damage to smaller veins.
D. A CVC also empties just above the heart muscle to be distributed.

4. Correct answer C: Parenteral nutrition is formulated to be administered directly into the bloodstream of patients whose digestive system is non-functional.

A. Parenteral nutrition goes directly into the bloodstream, bypassing the digestive system.
B. Enteral nutrition cannot be given IV as it must go through the digestive system to be processed.
D. Enteral nutrition is processed through the digestive system, usually through a tube that empties into the stomach.