The nurse is completing the intake and output record for a preschool-age client admitted for fluid volume deficit.

The client has had the following intake and output during the shift:

Intake:

4 oz of Pedialyte

1/2 of an 8-oz cup of clear orange Jell-O

2 graham crackers

200 mL of D 5-1/2 sodium chloride IV

Output:

345 mL of urine

50 mL of loose stool

The nurse documents the client's intake as milliliters. How much liquidintake did the client have in Milliliters?
Round the answer to the nearest whole number.

Answer and Explanation

The Correct Answer is ["437"]

To convert ounces to milliliters, multiply by 29.57
4 oz of Pedialyte = 118.28 mL
1/2 of an 8-oz cup of clear orange Jell-O = 118.28 mL
2 graham crackers = no liquid intake
200 mL of D 5-1/2 sodium chloride IV = 200 mL
Total intake = 118.28 + 118.28 + 200 = 436.56 mL
Round to the nearest whole number = 437 mL
The nurse documents the client's intake as 437 mL

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Correct Answer is C

Explanation

Choice A reason:

This statement is not directly related to the client's use of bisacodyl tablets. It addresses irregular bowel movements in a general sense.

Choice B reason:

Decreasing fiber intake is not a recommended approach, especially for an older adult who may benefit from a balanced diet with adequate fiber.

Choice C reason:

This is the correct answer. Excessive use of laxatives, including bisacodyl, can lead to electrolyte imbalances. Bisacodyl is a stimulant laxative that can cause excessive fluid loss and potentially

disrupt electrolyte levels.

Choice D reason:

While chronic use of laxatives can lead to various complications, including potential harm to the rectal mucosa, this choice is not the most appropriate response to the client's current situation.

Correct Answer is ["31.25"]

Explanation

To calculate the correct rate of flow for this patient, we need to use the formula: Rate (gtt/min) = Volume (mL) x Calibration (gtt/mL) / Time (min)
Plugging in the given values, we get: Rate (gtt/min) = 125 mL x 15 gtt/mL / 60 min
Simplifying, we get: Rate (gtt/min) = 31.25 gtt/min
Therefore, the correct rate of flow for this patient is 31.25 gtt/min

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A patient, admitted with a head injury, has an order for DSNS at 125 ml/hour. The IV tubing has a calibration of 15gtt/mL. What is the correct rate of flow for this patient in gtt/min?

Correct Answer is ["31.25"]

Explanation

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