A nurse is calculating the intake of a client during the past 9 hr. 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 6.0% sodium chloride, famotidine 20 mg IV intermittent bolus in 50 mL of 0.9% sodium chloride. How many mL of intake should the nurse record?
1,350 mL
1,600 mL
2525 mL
2,100 mL
The Correct Answer is C
The correct answer is c. 2,525 mL.
Choice A reason:
1,350 mL is calculated by considering only the lactated Ringer’s IV intake. The calculation is as follows:
- Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL. This option does not include the intake from cefazolin, packed RBCs, sodium chloride boluses, or famotidine.
Choice B reason:
1,600 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.
Choice C reason:
2,525 mL is the correct total intake. The detailed calculation is:
- Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL.
- Cefazolin in 100 mL of 0.9% sodium chloride: 100 mL.
- Two units of packed RBCs: 275 mL + 250 mL = 525 mL.
- Two IV bolus infusions of 250 mL of 6.0% sodium chloride: 250 mL + 250 mL = 500 mL.
- Famotidine in 50 mL of 0.9% sodium chloride: 50 mL.
Adding these together: 1,350 mL + 100 mL + 525 mL + 500 mL + 50 mL = 2,525 mL.
Choice D reason:
2,100 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is incorrect because constipation is not a common or serious adverse effect of antihistamines. However, the patient should increase their fluid and fiber intake and exercise regularly to prevent constipation.
Choice B reason: This is incorrect because abdominal cramps are not a common or serious adverse effect of antihistamines. However, the patient should avoid spicy or fatty foods and take the antihistamine with food or milk to prevent stomach irritation.
Choice C reason: This is correct because drowsiness is one of the most common and bothersome adverse effects of antihistamines. The patient should avoid driving or operating machinery if they experience drowsiness and take the antihistamine at bedtime.
Choice D reason: This is incorrect because decreased libido is not a common or serious adverse effect of antihistamines. However, the patient should inform their provider if they experience any sexual dysfunction or mood changes while taking the antihistamine.
Correct Answer is C
Explanation
Choice A reason: Rotating the injection sites within the same location for a week is not correct. The client should rotate the injection sites within the same location each day to prevent lipodystrophy and ensure consistent absorption.
Choice B reason: Storing the unopened vials of insulin in the freezer is not correct. The client should store the unopened vials of insulin in the refrigerator, not the freezer, to prevent damage to the insulin.
Choice C reason: Drawing up the regular insulin before the NPH insulin is correct. The client should draw up the clear (regular) insulin before the cloudy (NPH) insulin to prevent contamination of the regular insulin with the NPH insulin.
Choice D reason: Injecting the insulin into the muscle for faster absorption is not correct. The client should inject the insulin into the subcutaneous tissue, not the muscle, to ensure appropriate absorption and prevent hypoglycemia.
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