A nurse is calculating the intake of a client during the past 9 hours.

The client's intake includes:

Lactated Ringer's IV at 150 mL/hr

cefazolin 2 g IV intermittent bolus in 100 mL of 0.9% sodium chloride

two units of packed RBCs of 275 mL and 250 mL

two IV bolus infusions of 250 mL of 0.9% sodium chloride

ranitidine 50 mg IV intermittent bolus in 50 mL of dextrose 5% in water.

How many mL of intake should the nurse record?

Answer and Explanation

The Correct Answer is ["2525"]

Step 1 is calculate intake from lactated Ringer’s: 150 mL/hr × 9 hrs = 1350 mL.

Step 2 is calculate cefazolin intake: 100 mL × 1 dose = 100 mL.

Step 3 is calculate intake from two units of packed RBCs: 275 mL + 250 mL = 525 mL.

Step 4 is calculate intake from two IV boluses: 250 mL × 2 = 500 mL.

Step 5 is calculate intake from ranitidine infusion: 50 mL × 1 dose = 50 mL.

Step 6 is calculate total intake: 1350 mL + 100 mL + 525 mL + 500 mL + 50 mL = 2525 mL. Final calculated intake is 2525 mL.

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Correct Answer is C

Explanation

Choice A rationale

Soft restraints are utilized for agitation but are not prioritized in epilepsy care. Emergency equipment like suction ensures airway safety during seizures.

Choice B rationale

Glasgow Coma Scale evaluates neurological function but is less relevant for epilepsy management compared to essential tools like suction equipment for airway protection.

Choice C rationale

Suction equipment and oxygen are vital in epilepsy management to clear secretions and maintain oxygenation during seizures. Patent IV access allows rapid administration of emergency medications.

Choice D rationale

Dextrose infusion is used to treat hypoglycemia rather than seizures. Epilepsy care prioritizes tools like suction and oxygen for immediate seizure-related complications. .

A. Symmetry of extraocular movement. B. Both near and distant vision. C. Cloudiness in the lens of the eye. D. Intraocular pressure changes.

Correct Answer is B

Explanation

Choice A rationale

Symmetry of extraocular movements assesses cranial nerve function but does not relate to the corrective purpose of bifocals, which is addressing near and distant vision issues caused by presbyopia and myopia.

Choice B rationale

Bifocals correct presbyopia and myopia by combining lenses for near and distant vision in one frame. Effectiveness is assessed by evaluating improvements in both visual ranges, ensuring accommodation and refraction are properly corrected.

Choice C rationale

Cloudiness in the lens indicates cataracts, which bifocals cannot correct. Cataracts require surgical intervention, making this assessment irrelevant to determining bifocal lens effectiveness for presbyopia and myopia.

Choice D rationale

Intraocular pressure changes relate to glaucoma, not refractive issues like myopia or presbyopia. Monitoring for glaucoma requires tonometry, independent of bifocal lens evaluation.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with epilepsy who has recently had a change in their prescribed medication combination.Which of the following options are priority to institute?

Correct Answer is C

Explanation

A 64-year-old client is prescribed bifocals to correct myopia and presbyopia.To evaluate the effectiveness of the lenses, the nurse will assess the client for:

Correct Answer is B

Explanation

The nurse should educate clients who are HIV+ on proper nutrition, exercise, and stress reduction because these factors will: (Select All that Apply.)

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