PN-POST-TEST

Froggy Jumps

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PN POSTTEST

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Wessam

Egypt

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PN-POST-TEST


Froggy Jumps PN-POST-TESTOnline version PN POSTTEST by Wessam 1 A 60-year-old with a bowel obstruction is hemodynamically stable, has had no gut function for 4 days, is malnourished on assessment and the team expects at least 8 more days without gut function. What is the most appropriate next step? a use parentral nutrition b Start full oral diet as tolerated c Continue to wait and reassess in another week before considering PN 2 A severely malnourished patient (BMI 15, minimal intake for 3 weeks) is about to start PN. Yesterday's electrolytes were normal. What is the most appropriate action regarding today's labs? a Recheck electrolytes today and daily until stable, given high refeeding risk b Skip today's electrolytes since yesterday's were normal c Electrolyte monitoring is unnecessary if thiamine has been given 3 A patient on stable central PN for 6 days develops a glucose rise from 150 to 240 mg/dL overnight along with a new low-grade fever. What is the most appropriate first step? a Evaluate the catheter site and obtain blood cultures to assess for catheter-related infection and revise the glucose amount given by nurse b Simply increase the insulin dose and reassess tomorrow c Assume this is a normal PN side effect requiring no action 4 A patient with severe acute pancreatitis is started on PN with a lipid emulsion. Which laboratory value most directly guides ongoing lipid dosing in this patient? a Serum triglycerides b Hemoglobin A1c c albumin 5 A patient's enteral intake now reliably covers approximately 50% of estimated nutritional needs, with PN continuing to supply the remainder. What is the most appropriate next step? a Continue overlapping PN and enteral feeding, tapering PN once enteral/oral intake reaches roughly 60–75% of needs b Stop PN immediately now that enteral feeding has started c Increase PN rate and decrease enteral feeding 6 A patient will require home PN for an anticipated 6–8 months, administered intermittently several nights per week. Which catheter is most appropriate? a A tunneled catheter b Non-tunneled central venous catheter c Standard peripheral IV cannula 7 During interdisciplinary rounds, you notice a central line has been in place for 10 days without documented ongoing justification. What is the most appropriate action? a Raise the concern with the team — line necessity review is a shared responsibility for anyone who notices b Say nothing, since line necessity review is the physician's responsibility alone c Remove the line 8 A patient begins PN with calories advanced quickly on day 1 despite significant refeeding risk factors. By day 2, phosphate has dropped sharply and the patient is symptomatic. What most likely occurred, and what should have been done differently? a Refeeding syndrome — calories should have been advanced more slowly with electrolytes corrected proactively b This is an expected effect of amino acids alone and requires no intervention c This is unrelated to PN; no different approach was needed 9 A patient has been on central PN for 5 months. The team is screening for long-term complications. Which combination of monitoring and intervention is most appropriate for bone health? a Monitor calcium, phosphate, and vitamin D, and involve physiotherapy for weight-bearing activity b Bone health is only relevant if the patient reports pain c Restrict all physical activity to prevent fractures 10 A patient with a peripheral venous line reports new arm swelling and pain on the catheter side. What complication should be prioritized in the differential? a Catheter-associated venous thrombosis or infection b Refeeding syndrome c Metabolic bone disease

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PN-POST-TEST

Froggy Jumps

About this activity

Created by

Download the paper version to play

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PN-POST-TESTOnline version

by Wessam

A 60-year-old with a bowel obstruction is hemodynamically stable, has had no gut function for 4 days, is malnourished on assessment and the team expects at least 8 more days without gut function. What is the most appropriate next step?

A severely malnourished patient (BMI 15, minimal intake for 3 weeks) is about to start PN. Yesterday's electrolytes were normal. What is the most appropriate action regarding today's labs?

A patient on stable central PN for 6 days develops a glucose rise from 150 to 240 mg/dL overnight along with a new low-grade fever. What is the most appropriate first step?

A patient with severe acute pancreatitis is started on PN with a lipid emulsion. Which laboratory value most directly guides ongoing lipid dosing in this patient?

A patient's enteral intake now reliably covers approximately 50% of estimated nutritional needs, with PN continuing to supply the remainder. What is the most appropriate next step?

A patient will require home PN for an anticipated 6–8 months, administered intermittently several nights per week. Which catheter is most appropriate?

During interdisciplinary rounds, you notice a central line has been in place for 10 days without documented ongoing justification. What is the most appropriate action?

A patient begins PN with calories advanced quickly on day 1 despite significant refeeding risk factors. By day 2, phosphate has dropped sharply and the patient is symptomatic. What most likely occurred, and what should have been done differently?

A patient has been on central PN for 5 months. The team is screening for long-term complications. Which combination of monitoring and intervention is most appropriate for bone health?

A patient with a peripheral venous line reports new arm swelling and pain on the catheter side. What complication should be prioritized in the differential?