A nurse is to administer one 1L bag of normal saline to a client over 5 hours. At what rate should the nurse program the pump in milliliters per hour?

(Round to the whole number. Assume no interruptions.)

Answer and Explanation

The Correct Answer is ["200"]

To calculate the rate at which the nurse should program the pump in milliliters per hour, you can use the following formula:

Rate (mL/hour) = Volume (mL) / Time (hours)

In this case, the volume is 1,000 mL (1 liter), and the time is 5 hours. Plugging these values into the formula:

Rate (mL/hour) = 1,000 mL / 5 hours = 200 mL/hour

So, the nurse should program the pump to administer the normal saline at a rate of 200 milliliters per hour.

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Correct Answer is A

Explanation

A. Remove heel boots:
Heel boots are often used to protect the heels from pressure ulcers. However, it's important to assess the skin regularly and remove heel boots periodically to inspect the skin underneath. Leaving them on continuously without proper inspection can cause moisture buildup, leading to skin breakdown.

B. Reposition every 3 hours
Repositioning the client every 3 hours is a crucial intervention to prevent skin breakdown, especially in individuals at risk, such as older adults. Prolonged pressure on specific areas of the body can lead to pressure ulcers or bedsores. Regular repositioning helps relieve pressure on vulnerable areas, improving circulation and reducing the risk of skin breakdown.

C. Apply cornstarch to keep the skin dry:
While it's essential to keep the skin clean and dry, using cornstarch can sometimes lead to moisture retention, especially in skin folds. Excess moisture can contribute to skin breakdown and fungal infections. Instead, proper hygiene practices and the use of moisture-wicking products are recommended.

D. Provide high protein diet:
Adequate nutrition, including a high-protein diet, is essential for overall skin health and healing. Protein is necessary for tissue repair and regeneration. While a balanced diet is crucial for overall health, it is not a specific intervention solely focused on maintaining skin integrity.

A. Performing range of motion B. Managing pain C. Checking capillary refill D. Discussing cast care

Correct Answer is C

Explanation

A. Performing range of motion:
Explanation: Range of motion exercises are important for preventing joint stiffness and muscle atrophy, especially in clients with casts. However, this is not the first priority. Ensuring adequate circulation and perfusion is crucial before initiating any exercises or movements, as compromised circulation could lead to serious complications.

B. Managing pain:
Explanation: Pain management is important for the client's comfort, but it is not the first priority in this context. Assessing circulation and ensuring there are no signs of compromised perfusion takes precedence. Pain management can follow once circulation has been confirmed as adequate.

C. Checking capillary refill:
Explanation: Checking capillary refill is the first priority when assessing a client with a cast. Capillary refill assesses peripheral circulation by pressing on the nail bed and observing how quickly color returns. Delayed capillary refill could indicate compromised blood flow, which is a serious concern and requires immediate intervention.

D. Discussing cast care:
Explanation: Educating the client about cast care is important, but it is not the first priority. Ensuring proper circulation and ruling out any signs of impaired perfusion must be addressed before discussing cast care instructions.

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A nurse is to administer one 1L bag of normal saline to a client over 5 hours. At what rate should the nurse program the pump in milliliters per hour? (Round to the whole number. Assume no interruptions.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client who is at risk for skin breakdown. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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A nurse is to administer one 1L bag of normal saline to a client over 5 hours. At what rate should the nurse program the pump in milliliters per hour?

(Round to the whole number. Assume no interruptions.)