A nurse is recording the intake and output (I&O) for a client.
The client consumed 8 oz of milk, 10 oz of water, 4 oz of gelatin, 1 egg, 1 piece of bacon, and 2 biscuits.
Which volume should the nurse record on the I&O?
The Correct Answer is ["660"]
Step 1: Convert all liquid intake to mL: 8 oz of milk = 8 oz × 30 mL/oz = 240 mL 10 oz of water = 10 oz × 30 mL/oz = 300 mL 4 oz of gelatin = 4 oz × 30 mL/oz = 120 mL
Step 2: Sum the liquid intake: Total intake = 240 mL + 300 mL + 120 mL = 660 mL
The nurse should record 660 mL on the I&O.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
"Let's talk about what you're thinking.”. This response encourages open communication and allows the nurse to address any concerns or confusion the client may have. It shows empathy and helps build a therapeutic relationship.
Choice B rationale
"Is this something you think you can do?" While this question assesses the client's confidence, it may not address underlying concerns that cause distraction. The focus should be on understanding the client's thoughts and feelings first.
Choice C rationale
"Are you feeling okay?" This question is more about physical well-being, which may not be the reason for the client's distraction. It's better to address emotional or cognitive concerns related to the teaching session.
Choice D rationale
"Do you need more time to absorb this information?" While offering more time can be helpful, it doesn't directly address the client's distraction. Engaging the client in a conversation about their thoughts can be more effective in understanding their needs.
Correct Answer is D
Explanation
Choice A rationale
Verbal consent alone is not sufficient for invasive procedures like urinary catheter insertion. Documented consent is necessary to ensure legal and ethical compliance.
Choice B rationale
Having another nurse co-sign the consent does not verify the client's explicit agreement to the procedure. It is important that the client’s direct consent is documented.
Choice C rationale
Checking the medical record for a previous consent form may not reflect the client's current willingness. Consent should be obtained fresh to confirm current understanding and agreement.
Choice D rationale
Witnessing the client's signature on a consent form ensures that the client has been informed and agrees to the procedure, fulfilling both legal and ethical requirements.
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