A nurse is assessing a client's lower extremities and notes 6 mm pitting edema. Which of the following is appropriate documentation of this assessment finding?

Answer and Explanation

The Correct Answer is C

A. 1+ pitting edema is mild, with a slight indentation.

B. 4+ pitting edema is severe, with a deep indentation that lasts a long time.

C. 3+ pitting edema is moderate, with a deeper indentation that takes some time to rebound.
D. 2+ pitting edema is moderate, with a slight indentation that rebounds fairly quickly.

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Correct Answer is D

Explanation

A. The two-point gait requires partial weight-bearing on both legs, making it unsuitable for a client who can only bear weight on one leg.
B. The four-point gait also requires weight-bearing on both legs and provides maximum stability, but it is not appropriate for a client who can bear weight on only one leg.
C. The swing-through gait is generally used by clients with paralysis of the legs or for those who need to use both legs minimally while moving with crutches. It is not the most suitable option for a client with weight-bearing restrictions on one leg.
D. The three-point gait is the correct technique for a client who can bear weight on only one leg. In this gait, both crutches and the affected leg are moved forward together, followed by the weight-bearing leg. This method allows the client to ambulate safely while maintaining the non-weight-bearing leg off the ground.

Correct Answer is ["150"]

Explanation

The question is about calculating the IV infusion rate for a given solution and volume.

The formula for the infusion rate is: (volume in mL / time in hours) x drop factor in gtts/mL = infusion rate in gtts/min

The drop factor is usually given on the IV tubing package and varies depending on the type of tubing used.

For this question, we can assume a drop factor of 15 gtts/mL, which is common for macrodrip tubing.

Plugging in the numbers, we get: (1200 mL / 8 hr) x 15 gtts/mL = 2250 gtts/hr

To convert from gtts/hr to mL/hr, we divide by the drop factor: 2250 gtts/hr / 15 gtts/mL = 150 mL/hr

Therefore, the nurse should set the IV pump to deliver 150 mL/hr.

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A nurse is assessing a client's lower extremities and notes 6 mm pitting edema. Which of the following is appropriate documentation of this assessment finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who can bear weight on only one leg how to ambulate using crutches. Which of the following crutch gaits should the nurse plan to instruct this client to use?

Correct Answer is D

Explanation

A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 1,200 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero is applicable. Do not use a trailing zero.)

Correct Answer is ["150"]

Explanation

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