A client returns to the acute care unit following surgery with 0.9% normal saline infusing at 45 drops/minute through tubing with a drop factor of 60 drops per ml. The postoperative prescriptions include 0.9% normal saline at 75 ml/hour to alternate with Lactated Ringer's solution at 75 ml/hour. An intravenous infusion pump is not available. What action should the nurse implement?

Change the normal saline to a keep open rate until an infusion pump is available.

Increase the rate of the present normal saline infusion to 75 drops per minute.

Leave the normal saline at the current rate until an infusion pump is available.

Switch the saline to Lactated Ringer's solution infusing at 75 drops per minute.

Answer and Explanation

The Correct Answer is C

Choice A: Changing the normal saline to a keep-open rate (KVO) is not appropriate in this situation, as the client has specific fluid orders that need to be followed, and a KVO rate would not provide the prescribed maintenance fluids.

Choice B: Increasing the rate of the present normal saline infusion to 75 drops per minute would not meet the prescription for 0.9% normal saline at 75 ml/hour.

Adjusting the rate this way would require an infusion pump.

Choice C: Leaving the normal saline at the current rate until an infusion pump is available is the most appropriate action. It ensures that the client continues to receive fluids at the ordered rate until the necessary equipment is in place.

Choice D: Switching the saline to Lactated Ringer's solution infusing at 75 drops per minute would not meet the prescribed rate for the normal saline solution. The nurse should follow the specific orders provided.

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Correct Answer is C

Explanation

Choice A: CPR is important but should be performed in conjunction with defibrillation. Since two defibrillation shocks have already been administered, the next step should be another shock.

Choice B : Obtaining an arterial blood gas sample is not the immediate priority when the client is in ventricular fibrillation. Defibrillation should be continued.

Choice C: Performing the third defibrillation shock is the next appropriate step in the advanced cardiac life support (ACLS) algorithm for ventricular fibrillation.

Choice D: Administering an IV bolus of epinephrine may be part of the ACLS protocol, but it is typically administered after defibrillation attempts.

A. Oranges B. Fortified milk. C. Bananas D. Apple juice.

Correct Answer is B

Explanation

Choice A: Oranges are a good source of vitamin C, which is important for overall health, but they are not the primary dietary source for preventing rickets.

Choice B: Fortified milk is the best dietary source for preventing rickets because it is enriched with vitamin D, which is essential for calcium absorption and bone health. Vitamin D helps prevent rickets by promoting the absorption of calcium and phosphate in the body, which are necessary for proper bone development.

Choice C: Bananas are a good source of potassium but are not a primary dietary source for preventing rickets.

Choice D: Apple juice is not a primary dietary source for preventing rickets. While it may provide some vitamins and minerals, it is not directly associated with preventing this condition.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Following two defibrillation shocks, the client's electrocardiogram (ECG) continues to indicate ventricular fibrillation (VF). Which intervention should the nurse implement next?

Correct Answer is C

Explanation

In conducting community health teaching, the nurse plans to describe foods that will help prevent rickets. What food product should the nurse recommend as the best dietary source for preventing rickets?

Correct Answer is B

Explanation

When the nurse is designing a plan of care for a client diagnosed with pheochromocytoma, a goal statement should be prepared that relates to which topic?

When conducting diet teaching for a client diagnosed with hypokalemia, which foods should the nurse encourage the client to eat?

The practical nurse (PN) is caring for a 3-month-old male infant two days after a pylorotomy and notices that the infant is restless, grimacing, and drawing his knees to his chest. What action should the PN implement?

When conducting diet teaching for a client who is on a gastrostomy tube feeding, which foods should the nurse encourage the client use? (Select all that apply.)

A 16-year-old female client who attempted suicide that morning is admitted to the psychiatric unit. To determine the seriousness of the adolescent's suicide attempt, which question is most important for the nurse to ask the family?

The nurse is caring for a client diagnosed with type 1 diabetes mellitus who uses both short-acting and long-acting insulin adjusted doses throughout the day. Which nutrient is essential for the client to count for each meal and snacks?

A 30-year-old male client tells the nurse that about half of his diet comes from eating meat and eggs. What instruction should the nurse provide?

While assessing placement of a nasogastric tube (NGT), the nurse aspirates cloudy green fluid into a syringe. Which intervention should the nurse Implement?