A nurse is calculating a client's fluid intake over the past 8 hr. The client had one 8-oz cup of coffee, 3 oz of juice, and 12 oz of soda. The client's water pitcher had 300 ml and 200 ml remains. The client also had IV fluids infusing as 40 mL/hr via an infusion pump. How many ml should the nurse document as the client's total Intake for the shift?
The Correct Answer is ["1110"]
8-oz cup of coffee = 8 oz (since 1 fluid ounce is approximately 30 ml, this is roughly 240 ml).
3 oz of juice = 3 oz (approximately 90 ml).
12 oz of soda = 12 oz (approximately 360 ml).
Water pitcher had 300 ml, and 200 ml remains, so the client consumed 300 ml - 200 ml = 100 ml of water.
IV fluids infusing at 40 mL/hr for 8 hours = 40 ml/hr * 8 hr = 320 ml.
Now, sum up these values:
240 ml (coffee) + 90 ml (juice) + 360 ml (soda) + 100 ml (water) + 320 ml (IV fluids) = 1,110 ml
So, the nurse should document the client's total intake for the shift as 1,110 ml.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Diabetes mellitus
Diabetes mellitus can cause easy bruising and slow wound healing, but it is not typically associated with frequent nosebleeds.
B. Hepatitis A
Hepatitis A primarily affects the liver and does not cause frequent bruising and nosebleeds.
C. Cirrhosis
Cirrhosis, which is scarring of the liver tissue due to long-term liver damage, can lead to impaired liver function. One consequence of cirrhosis is decreased production of clotting factors, which can result in easy bruising. Additionally, the enlarged spleen in cirrhosis can lead to thrombocytopenia (low platelet count), contributing to bleeding tendencies, including nosebleeds. Cirrhosis is the most likely condition given the symptoms described.
D. Cholecystitis
Cholecystitis is inflammation of the gallbladder and is not directly associated with frequent bruising and nosebleeds.
Correct Answer is B
Explanation
A. Troponin:
Troponin is a protein found in the heart muscle. Elevated levels of troponin in the blood indicate damage to the heart, often due to a heart attack or other cardiac issues. This marker is crucial in diagnosing heart-related problems.
B. Albumin:
Albumin is a protein produced by the liver and is essential for maintaining blood volume and regulating fluid balance. It also helps transport various substances in the blood. Low levels of albumin are indicative of malnutrition, liver disease, or kidney disorders.
C. D-dimer:
D-dimer is a substance in the blood that is released when a blood clot breaks up. Elevated levels of D-dimer can indicate the presence of an abnormal blood clot, but it is not specific to malnutrition. It is often used in diagnosing conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE).
D. Creatinine:
Creatinine is a waste product produced by the muscles and excreted by the kidneys. Creatinine levels in the blood can indicate how well the kidneys are functioning. Elevated levels can suggest kidney damage or other kidney-related issues but are not directly related to malnutrition.
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