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.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A: The client's statement reflects an understanding of the DASH diet's emphasis on lean meats, nuts, and dried beans as protein sources, which aligns with the principles of the diet.

Choice B: The DASH diet encourages the consumption of more than 4 to 6 servings of fruits and vegetables daily.

Choice C: The DASH diet does not eliminate dairy-based products but recommends choosing low-fat or fat-free options.

Choice D: The DASH diet does not focus on gluten-free foods but rather on overall dietary patterns that promote heart-healthy eating.

A. I will withhold the antacid for now, and if you get indigestion, I will bring it back. B. CKD stresses your body to over-secrete gastric juices, and antacids help neutralize them. C. Your serum phosphate levels are up, and aluminum antacids prevent absorption of phosphates in foods. D. OK, I will let your healthcare provider know that you do not need the antacid.

Correct Answer is C

Explanation

Choice A: Withholding the antacid until the client gets indigestion is not appropriate because the primary purpose of aluminum hydroxide in CKD is to bind to phosphates in foods and reduce their absorption. It is not primarily used for indigestion.

Choice B: While CKD can lead to disturbances in gastric acid secretion, aluminum antacids are primarily used in CKD to control hyperphosphatemia by binding to phosphates in the gastrointestinal tract. Their role is not primarily related to gastric acid control.

Choice C: This response provides the most appropriate rationale. Aluminum antacids are often prescribed to CKD clients to prevent the absorption of dietary phosphates, which can contribute to hyperphosphatemia in CKD.

Choice D: Simply informing the healthcare provider that the client does not want to take the antacid is not the most informative response, as it does not address the rationale behind the medication use in CKD.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing a nutrition plan with a client newly diagnosed with hypertension. Which statement by the client indicates an understanding of the Dietary Approaches to Stop Hypertension (DASH) diet?

Correct Answer is A

Explanation

An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

Correct Answer is C

Explanation

A client expresses an interest in reducing intake of saturated fats and plans to stop eating hamburgers at lunch. Which menu item should the nurse suggest as an alternative source of protein?

When assessing both lower extremities (BLE) of a client who has chronic venous insufficiency, the nurse identifies bilateral stasis dermatitis and an ulcer on the medial surface of the left ankle. To promote effective self-care, which client teaching should the nurse provide?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?

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

The practical nurse (PN) observes an infant searching for a fallen toy. According to Piaget, which additional finding should the PN correlate with this developmental stage?

The nurse-manager of a pediatric unit needs to assign a room for a 6-month-old diagnosed with respiratory syncytial virus (RSV). Which room assignment is best for the nurse-manager to make?

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?