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 ["B","C"]
Explanation
Choice A rationale:
This statement is incorrect. Sulfonamides should be taken for the full time of treatment, even if the patient begins to feel better after a few days. If the medication is stopped too soon, the symptoms may return.
Choice B rationale:
This statement is correct. Sulfonamides can cause increased photosensitivity, which means the skin can be more sensitive to the sun and burn more easily. Therefore, patients should be educated to use sunscreen and protective clothing with sun exposure.
Choice C rationale:
This statement is correct. Sulfonamides are best taken with a full glass (8 ounces) of water. Several additional glasses of water should be taken every day, unless otherwise directed by the doctor. Drinking extra water will help to prevent some unwanted effects of sulfonamides.
Choice D rationale:
This statement is incorrect. Restricting daily fluid intake to 1000ml per day while on sulfonamides could increase the risk of crystalluria that can cause kidney stones or decreased kidney function. Therefore, patients should increase their water intake while taking these medications.
Correct Answer is A
Explanation
Choice A rationale:
Phenytoin is an anticonvulsant drug used in the prophylaxis and control of various types of seizures. It has a narrow therapeutic index, which means that the safe and toxic plasma levels of the drug are very close to each other. This characteristic makes the dosing of phenytoin challenging, as even small deviations from the recommended therapeutic range can lead to suboptimal treatment or adverse effects. Therapeutic effect without clinical signs of toxicity occurs more often with serum total concentrations between 10 and 20 mcg/mL34. Therefore, clinicians are advised to initiate therapeutic drug monitoring in patients who require phenytoin.
Choice B rationale:
The statement that phenytoin has a low chance of being effective is incorrect. Phenytoin is a widely used and effective anticonvulsant. It works by slowing down impulses in the brain that cause seizures. It is used to control seizures but does not treat all types of seizures. The effectiveness of phenytoin is not determined by its narrow therapeutic index but by its pharmacological action in the brain.
Choice C rationale:
The assertion that there is no difference between safe and toxic plasma levels of phenytoin is incorrect. There is indeed a difference between the safe (therapeutic) and toxic levels of phenytoin. The therapeutic range for phenytoin is typically between 10 and 20 mcg/mL34. Levels above this range can lead to toxicity, while levels below this range may not provide the desired therapeutic effect.
Choice D rationale:
The statement that a very small dosage of phenytoin can result in the desired therapeutic effect is not entirely accurate. While it’s true that phenytoin is effective in controlling seizures, the dosage required to achieve this effect is not necessarily “very small”. The usual adult dose for seizures is 100 mg orally 3 times a day. The dosage may need to be adjusted based on individual patient factors and response to therapy. Therefore, it’s not accurate to generalize that a “very small” dosage will result in the desired therapeutic effect for all patients.
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