A nurse is caring for a client who consumes 3 ounces of milk, 2 ounces of orange juice, 3 ounces of tea, and 4 ounces of water over a 4-hour period. The client is also receiving dextrose 5% in 0.45% sodium chloride at a rate of 30 mL/hr by continuous IV infusion. Calculate the client’s intake for that 4-hr period in mL.
(Round the answer to the nearest whole number. Use a leading zero if it applies. DO not use a trailing zero.)
The Correct Answer is ["480"]
480 mL.
The client's total oral intake over the 4-hour period is 3 ounces of milk + 2 ounces of orange juice + 3 ounces of tea + 4 ounces of water = 12 ounces. Since there are approximately 30 mL in 1 ounce, the client's oral intake in mL is 12 ounces * 30 mL/ounce = 360 mL.
The client is also receiving dextrose 5% in 0.45% sodium chloride at a rate of 30 mL/hr by continuous IV infusion. Over a 4-hour period, the client will receive a total of 30 mL/hr * 4 hours = 120 mL from the IV infusion.
Therefore, the client's total intake for that 4-hour period is 360 mL (oral intake. + 120 mL (IV infusion) = 480 mL.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
The priority intervention for a client with a new diagnosis of terminal cancer is to discuss the client's prior coping mechanisms. This will help the nurse to understand how the client has coped with difficult situations in the past and to develop a plan of care that is tailored to the client's individual needs and preferences.
Options a, c, and d are also important interventions, but they are not the priority. Helping the client to find a local support group, developing a list of goals with the client, and teaching the client to use progressive relaxation techniques can all be helpful in supporting the client's emotional well-being, but they should be implemented after the nurse has assessed the client's coping mechanisms and developed a plan of care.
Correct Answer is B
Explanation
The client's belief that their needs will be met through education is the most likely factor to increase their motivation to learn how to self-administer daily low-dose heparin injections. When a client believes that they will benefit from the education and that it will help them meet their needs, they are more likely to be motivated to learn.
a. The nurse's empathy about the client having to self-inject may help build rapport with the client, but it is not the most important factor in increasing the client's motivation to learn.
c) The client seeking family approval by agreeing to a teaching plan may be a motivating factor for some clients, but it is not the most important factor in increasing the client's motivation to learn.
d) The nurse explaining the need for education to the client may help increase the client's understanding of the importance of learning how to self-administer heparin injections, but it is not the most important factor in increasing the client's motivation to learn.
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