A client is admitted to the unit at 1500. The provider has prescribed a full liquid diet for the client. The client ingests the following from 1600 to 2115:

Chicken broth: 120 mL

Tea: 4 ounces

Ice cream: 1 cup

Soda: 6 ounce can

Water: 550 mL

Ice chips: 500 mL

The client voids the following:

At 1530: 400 mL

At 2015: 775 mL

At 2245: 200 mL

Calculate the cumulative fluid intake for the 3 p.m. to 11 p.m. shift. Note that intake and output is calculated at 2200 for the 3 p.m.-11 p.m. shift. (Round to the nearest whole number, use a preceding zero, do not use trailing zeros)

Answer and Explanation

The Correct Answer is ["1705"]

To calculate the cumulative fluid intake for the client from 3 p.m. to 11 p.m., convert all measurements to the same unit and then sum them up.

First, convert ounces to milliliters (1 ounce = 29.5735 ml). The tea is 4 ounces, which is approximately 118 ml, and the soda is 6 ounces, approximately 177 ml.

Add all the liquid intake: chicken broth (120 ml) + tea (118 ml) + ice cream (assumed to be 240 ml for 1 cup) + soda (177 ml) + water (550 ml) + half the volume of ice chips (as half the volume of ice chips is water, so 250 ml). The total intake is 120 + 118 + 240 + 177 + 550 + 500= 1705 ml.

Since the intake and output are calculated at 2200, and the client has not consumed anything after 2115, the cumulative fluid intake for the shift is 1705 ml.

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Correct Answer is C

Explanation

C. This reflex is an important protective mechanism that prevents objects from entering the throat and causing choking. Assessing the gag reflex before oral care can help ensure the safety of the client, especially if they have difficulty swallowing or are at risk for aspiration.

A. It's important to assess if the client is experiencing any pain, as oral care procedures can sometimes cause discomfort, especially if the client has oral lesions or sensitive gums. However, it is not a priority.

B. Presence of saliva: Saliva is essential for oral health, as it helps to cleanse the mouth and buffer acids produced by bacteria. Assessing the amount of saliva can indicate the overall oral hydration status and potential risk of dry mouth (xerostomia).

D. assessing the condition of the skin around the mouth and on the lips is important. It can reveal issues such as dryness, cracking, lesions, or signs of infection but not directly related to oral care.

A. respiratory alkalosis. B. respiratory acidosis. C. metabolic acidosis. D. metabolic alkalosis.

Correct Answer is D

Explanation

D. Metabolic alkalosis is characterized by an increased pH (alkalosis) and an increased HCO3. In this case, the pH is elevated (7.5), indicating alkalosis, which supports metabolic alkalosis. The HCO3 is elevated at 40 mEq/L, which further supports metabolic alkalosis. The PaCO2 is normal or slightly low (36 mmHg), which can occur as a compensatory response to metabolic alkalosis.

A. Respiratory alkalosis is characterized by an increase in pH (alkalosis) and a decrease in PaCO2 (hypocapnia). In this scenario, the pH is elevated (7.5), which indicates alkalosis. The PaCO2 is 36 mmHg, which is within the normal range (35-45 mmHg) but slightly on the lower side (slight hypocapnia). The HCO3 is elevated at 40 mEq/L, which suggests a compensatory response by the kidneys to retain bicarbonate to counteract the alkalosis.

B. Respiratory acidosis is characterized by a decrease in pH (acidosis) and an increase in PaCO2 (hypercapnia). In this case, the pH is elevated (7.5), indicating alkalosis, which contradicts respiratory acidosis. The PaCO2 is 36 mmHg, which is normal or slightly low, not high as expected in respiratory acidosis. The elevated HCO3 (40 mEq/L) suggests a compensatory metabolic response to the alkalosis, not to acidosis.

C. Metabolic acidosis is characterized by a decreased pH (acidosis) and a decreased HCO3. In this scenario, the pH is elevated (7.5), indicating alkalosis, which contradicts metabolic acidosis. The HCO3 is elevated at 40 mEq/L, indicating metabolic alkalosis rather than metabolic acidosis.

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Naxlex Comprehensive Predictor Exams

A client requires complete care with ADL's. Before providing oral care, the nurse should assess for which of the following?

Correct Answer is C

Explanation

A client is admitted to the medical-surgical unit with a chief complaint of prolonged vomiting over the past 24 hours. Based on the arterial blood gas (ABG) results of pH 7.5. PaCO2 36, HCO3 40, the nurse determines that the client is experiencing:

Correct Answer is D

Explanation

The nurse reviews the list of medications that will be administered through a client's new gastrostomy tube. All medications were previously given PO. Which medication order will the nurse question?

The nurse recognizes that which statement correctly characterizes drug absorption?

The nurse identifies that the client understands an intervention for reestablishing bowel flora after a week of diarrhea, when the client states. "I'm going to:

The nurse finds a client's pulse to be very weak, but palpable. Documentation should note that this pulse is:

The nurse prepares to assess the client's radial pulse. Which statement made by the nurse reflects a correct understanding of the procedure? "I will:

As a part of care planning, the nurse considers the client's spiritual needs. What is the Rationale for this concern?

A client is receiving IV fluids at 100 ml per hour. The nurse is told in report at 1200 that there are 500 ml left in the bag. At what time should the nurse expect to hang a new bag? Report the time in military time.