A nurse is documenting an 8-hour intake and output (I&O) record for a patient who consumed 4 oz of juice, 6 oz of tea, a 100 mL cup of soda, an IV bolus of 150 mL, and 8 oz of broth. How many mL of intake should the nurse record on the patient’s chart?
500 mL
600 mL
700 mL
800 mL
The Correct Answer is D
The correct answer is Choice D.
Let’s go through the calculations step by step:
Step 1: Convert all the quantities to milliliters (mL), as the nurse needs to record the intake in mL. We know that 1 oz is approximately 29.5735 mL.
4 oz of juice = 4 × 29.5735 mL = 118.294 mL
6 oz of tea = 6 × 29.5735 mL = 177.861 mL 8 oz of broth = 8 × 29.5735 mL = 236.628 mL Step 2: Add all the quantities together:
118.294 mL (juice) + 177.861 mL (tea) + 100 mL (soda) + 150 mL (IV bolus) + 236.628 mL (broth) = 783.783 mL Step 3: Round off the total intake to the nearest whole number as required, which gives us 784 mL.
Therefore, the nurse should record 784 mL on the patient’s chart. However, this option is not available in the choices given. The closest option to this calculated value is 800 mL (Choice D).
Now, let’s discuss the rationales for each choice:
Choice A rationale:
500 mL would be an underestimate of the patient’s fluid intake. It does not account for all the fluids the patient consumed.
Choice B rationale:
600 mL, similar to Choice A, is an underestimate. It does not accurately represent the total volume of fluids the patient consumed. Choice C rationale:
700 mL is closer to the calculated intake but is still an underestimate. It does not fully account for all the fluids the patient consumed.
Choice D rationale:
800 mL is the closest option to the calculated intake of 784 mL. Although it’s slightly over the actual intake, it’s the best choice among the given options.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Blood glucose levels are not typically affected by rifampin and pyrazinamide. These medications are primarily used to treat tuberculosis and do not have a direct impact on blood sugar levels.
Choice B rationale:
Thyroid function studies are not usually required when a patient is on rifampin and pyrazinamide. These medications do not typically affect the thyroid gland or its function.
Choice C rationale:
Liver function tests are crucial when a patient is on rifampin and pyrazinamide. Both of these medications can cause liver problems, including hepatitis. Therefore, regular monitoring of liver function is necessary to detect any potential damage early and adjust the treatment plan accordingly.
Choice D rationale:
Gallbladder studies are not typically required for patients on rifampin and pyrazinamide. These medications do not have a known direct impact on the gallbladder.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale:
Shortness of breath is a common symptom of a hypersensitivity reaction. This occurs because the body’s immune system responds to a foreign substance, known as an antigen, by producing specific antibodies. This immune response can cause inflammation and swelling in various parts of the body, including the airways, leading to shortness of breath.
Choice B rationale:
A black hairy tongue is not typically associated with a hypersensitivity reaction. It is a condition that causes the tongue to appear black and hairy, and it’s usually caused by an overgrowth of bacteria or yeast on the tongue. It’s not related to allergies or hypersensitivity reactions.
Choice C rationale:
Itching is another common symptom of a hypersensitivity reaction. When the body encounters an antigen, it triggers an immune response that releases chemicals like histamine. Histamine can cause itching, among other symptoms.
Choice D rationale:
Swelling of the tongue can be a symptom of a severe hypersensitivity reaction known as anaphylaxis. This is a medical emergency that requires immediate attention. The swelling is caused by inflammation in response to an antigen.
Choice E rationale:
Wheezing is a symptom of a hypersensitivity reaction, specifically type I hypersensitivity. This type of reaction includes allergic disorders, which affect the lungs among other parts of the body. The immune response to an antigen can cause the airways to narrow and produce a wheezing sound.
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