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 of the following volumes should the nurse record on the I&O?
440 mL
660 mL
330 mL
550 mL
The Correct Answer is B
A) To calculate the intake volume for the I&O chart, the nurse should convert all liquid measurements to milliliters. One ounce is approximately 30 milliliters. Therefore, 8 oz of milk is 240 mL, 10 oz of water is 300 mL, and 4 oz of gelatin (since it's considered a liquid for I&O purposes) is 120 mL. The egg, bacon, and biscuits are not included in the liquid intake calculation. Adding up the liquids, the total intake is 240 mL + 300 mL + 120 mL, which equals 660 mL.
B) To calculate the intake volume for the I&O chart, the nurse should convert all liquid measurements to milliliters. One ounce is approximately 30 milliliters. Therefore, 8 oz of milk is 240 mL, 10 oz of water is 300 mL, and 4 oz of gelatin (since it's considered a liquid for I&O purposes) is 120 mL. The egg, bacon, and biscuits are not included in the liquid intake calculation. Adding up the liquids, the total intake is 240 mL + 300 mL + 120 mL, which equals 660 mL.
C) To calculate the intake volume for the I&O chart, the nurse should convert all liquid measurements to milliliters. One ounce is approximately 30 milliliters. Therefore, 8 oz of milk is 240 mL, 10 oz of water is 300 mL, and 4 oz of gelatin (since it's considered a liquid for I&O purposes) is 120 mL. The egg, bacon, and biscuits are not included in the liquid intake calculation. Adding up the liquids, the total intake is 240 mL + 300 mL + 120 mL, which equals 660 mL.
D) To calculate the intake volume for the I&O chart, the nurse should convert all liquid measurements to milliliters. One ounce is approximately 30 milliliters. Therefore, 8 oz of milk is 240 mL, 10 oz of water is 300 mL, and 4 oz of gelatin (since it's considered a liquid for I&O purposes) is 120 mL. The egg, bacon, and biscuits are not included in the liquid intake calculation. Adding up the liquids, the total intake is 240 mL + 300 mL + 120 mL, which equals 660 mL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Request a change in the medication route to PO. - If the client is afraid of needles, and if methadone can be effectively administered orally (PO), changing the route of administration to oral may be a reasonable alternative.
B) Remind the client that they must receive the medication as prescribed. - While important to ensure adherence to the prescribed treatment, it's also essential to address the client's concerns and preferences.
C) Tell the client not to worry because the pain will be temporary. - Dismissing the client's fear with reassurance about temporary pain may not adequately address their anxiety.
D) Ask one of the client's loved ones to encourage them to receive the IM medication.
- Involving loved ones may be helpful, but the client's preference should be respected, and alternative options should be explored.
Correct Answer is C
Explanation
A) The stoma protrudes slightly from the abdomen. - A slightly protruding stoma is a normal finding following colostomy surgery and does not require reporting.
B) The stoma bleeds lightly when touched. - Minor bleeding may occur, especially in the immediate postoperative period, and typically resolves without intervention.
C) The stoma appears dark in color. - A dark or dusky stoma may indicate compromised blood supply and should be reported promptly to the provider.
D) The stoma is draining a small amount of liquid stool. - Stoma output varies among individuals and can include liquid stool, which is a normal finding post-colostomy surgery.
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