A client who weighs 176 pounds is admitted to the intensive care unit with a serum glucose level of 600 mg/dL (33.3 mmol/L). Regular insulin at a rate of 0.1 unit/kg/hour is prescribed. The pharmacy provides a solution of regular insulin 100 units/100 mL of normal saline.

The nurse should set the infusion pump to deliver how many mL/hours?

(Enter numeric value only.)

Answer and Explanation

The Correct Answer is ["8"]

Step 1: Convert the client's weight from pounds to kilograms. 176 pounds ÷ 2.2 = 80 kg

Step 2: Determine the total units of insulin needed per hour. 80 kg × 0.1 unit/kg/hour = 8 units/hour

Step 3: Determine the volume of insulin solution needed per hour. (8 units) ÷ (100 units/100 mL) = (8 units) ÷ (1 unit/mL) = 8 mL/hour

So, the nurse should set the infusion pump to deliver 8 mL/hour.

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Correct Answer is C

Explanation

Choice A reason: Lung sounds are important to assess for signs of fluid in the lungs, such as crackles, which can occur with fluid volume overload. However, they do not directly measure fluid balance.

Choice B reason: Turgor assesses skin elasticity and hydration status, but it is not the most accurate indicator of overall fluid balance in the context of fluid volume overload.

Choice C reason: Weight is the most accurate and direct measure of fluid balance. Daily weight monitoring can track changes in fluid status, as weight fluctuations can reflect gains or losses in body fluid.

Choice D reason: Blood pressure is important to monitor, especially in clients with fluid volume issues, but it is not the most direct measure of fluid balance. Weight changes provide more precise information about fluid status.

A. A haemoglobin of 12 g/dL (7.45 mmol/L) and haematocrit of 42% (0.42 volume fraction). B. Vital signs are temperature 99.0°F (37.2°C) orally, heart rate 94 beats/minute, respirations 18 breaths/minute, blood pressure 110/70 mm Hg. C. Vomits coffee-grounds emesis. D. Reports having sharp epigastric pain.

Correct Answer is C

Explanation

Choice A reason: A haemoglobin level of 12 g/dL (7.45 mmol/L) and haematocrit of 42% (0.42 volume fraction) are slightly lower than the reference range but not critically low. This finding is important and needs to be monitored, but it does not require the most immediate intervention.

Choice B reason: The vital signs provided are within normal limits and do not indicate an urgent or life-threatening condition. These should be monitored, but they do not require immediate intervention compared to other findings.

Choice C reason: Vomiting coffee-grounds emesis is a sign of gastrointestinal bleeding, specifically indicating that blood has been in the stomach long enough to be partially digested by stomach acid, giving it a coffee-grounds appearance. This is a serious and potentially life-threatening condition requiring immediate medical intervention to stop the bleeding and prevent further complications.

Choice D reason: Sharp epigastric pain is a common symptom of peptic ulcer disease and indicates inflammation or ulceration. While it is painful and concerning, it does not require the most immediate intervention compared to active gastrointestinal bleeding.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client with peptic ulcer disease (PUD) is admitted to the medical unit. Which assessment finding requires the most immediate intervention by the nurse?

Correct Answer is C

Explanation

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