Option A: Total Parenteral Nutrition (TPN) requires the use of a large vessel, such as the subclavian or jugular vein, to ensure rapid dilution of the solution and thereby prevent complications, such as hyperglycemia. The brachial and femoral veins usually are contraindicated because they pose an increased risk of thrombophlebitis.

Option D: The ELISA test of venous blood is used to assess blood and potential blood donors to human immunodeficiency virus (HIV). A positive ELISA test combined with various signs and symptoms helps to diagnose acquired immunodeficiency syndrome (AIDS)

Option D: Maintaining the drainage tubing and collection bag level with the patient’s bladder could result in reflux of urine into the kidney. Irrigating the bladder with Neosporin and clamping the catheter for 1 hour every 4 hours must be prescribed by a physician.

Option A: The main sources of vitamin A are yellow and green vegetables (such as carrots, sweet potatoes, squash, spinach, collard greens, broccoli, and cabbage) and yellow fruits (such as apricots, and cantaloupe). Animal sources include liver, kidneys, cream, butter, and egg yolks.

Option D: In the evaluation step of the nursing process, the nurse must decide whether the patient has achieved the expected outcome that was identified in the planning phase.

Option D: Bile colors the stool brown. Any inflammation or obstruction that impairs bile flow will affect the stool pigment, yielding light, clay-colored stool.
Option A: Upper GI bleeding results in black or tarry stool.
Option B: Constipation is characterized by small, hard masses.
Option C: Many medications and foods will discolor stool – for example, drugs containing iron turn stool black.; beets turn stool red.

Option D: Microorganisms usually do not grow in an acidic environment.

Option D: A clinical nurse specialist must have completed a master’s degree in a clinical specialty and be a registered professional nurse.
Option A: The National League of Nursing accredits educational programs in nursing and provides a testing service to evaluate student nursing competence but it does not certify nurses.
Option B: The American Nurses Association identifies requirements for certification and offers examinations for certification in many areas of nursing, such as medical-surgical nursing. This certification (credentialing) demonstrates that the nurse has the knowledge and the ability to provide high-quality nursing care in the area of her certification.
Option C: A graduate of an associate degree program is not a clinical nurse specialist: however, she is prepared to provide bedside nursing with a high degree of knowledge and skill. She must successfully complete the licensing examination to become a registered professional nurse.

Option C: In an infected patient, shivering results from the body’s attempt to increase heat production and the production of neutrophils and phagocytic action through increased skeletal muscle tension and contractions. Initial vasoconstriction may cause skin to feel cold to the touch. Applying additional bed clothes helps to equalize the body temperature and stop the chills. Attempts to cool the body result in further shivering, increased metabolism, and thus increased heat production.

Option A: Coughing, a protective response that clears the respiratory tract of irritants, usually is involuntary.
Option B: However, it can be voluntary as when a patient is taught to perform coughing exercises.
Option C: An antitussive drug inhibits coughing.
Option D: Splinting the abdomen supports the abdominal muscles when a patient coughs.