The nurse assesses a client's fluid intake at breakfast, which consisted of oatmeal, a cup of milk, and 12 ounces of coffee. How many mL should the nurse document in the client's record?
(Enter numerical value only to 0 decimal places)
The Correct Answer is ["595"]
To calculate the fluid intake, you need to convert each type of drink to millilitres (mL) and then sum them up:
Oatmeal: Oatmeal is usually consumed as a solid, so it doesn't contribute to fluid intake.
Cup of milk: Depending on the size of the cup, let's assume it's 240 mL (a common serving size for a cup of milk).
12 ounces of coffee: Convert ounces to millilitres. 1 fluid ounce is approximately 29.5735 mL, so 12 ounces is roughly 354.882 mL.
Total fluid intake = Milk + Coffee Total fluid intake = 240 mL + 354.882 mL Total fluid intake = approx 595 mL
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A
Client with a nasogastric tube to low, intermittent suction is not correct. While there is a risk of aspiration with a nasogastric tube in place, the tube is intended to help drain stomach contents, reducing the risk of aspiration. However, if the tube is not properly positioned or managed, there could still be some risk.
Choice B
Client who has sensory aphasia and is receiving a clear liquid diet is correct. Sensory aphasia refers to a language disorder that affects a person's ability to understand language and communication. This client may have difficulty swallowing safely and effectively, which increases the risk of aspiration. Additionally, a clear liquid diet consists of thin liquids that are more likely to be aspirated compared to thicker fluids.
Choice C
Client receiving 30% oxygen via a non-rebreather face mask is not correct. Oxygen therapy can increase the risk of drying the airways and potentially increasing the risk of aspiration, but if the oxygen mask is properly fitted and humidified, the risk may be minimized.
Choice D
Client experiencing dysphagia who is prescribed a full liquid diet is not correct. Dysphagia refers to difficulty swallowing, which can increase the risk of aspiration. However, a full liquid diet includes thicker liquids that are less likely to be aspirated compared to thin liquids. Still, the risk of aspiration exists, especially if the client has severe dysphagia.
Correct Answer is D
Explanation
Choice A
Sweaty palms are incorrect. Sweaty palms could be a normal response to physical activity and might not necessarily indicate a significant underlying issue.
Choice B
Bunions are incorrect. While bunions can cause discomfort, they might not be directly related to overall health, especially in comparison to fatigue.
Choice C
Dry skin is incorrect. Dry skin could be related to various factors, including environmental conditions or skincare habits. While it's worth addressing, it might not be as immediately concerning as unexplained fatigue.
Choice D
Fatigue is correct. For a professional dancer, fatigue should be an issue that alerts the nurse to perform further assessment. While all of the options can provide information about the client's health, fatigue in a professional dancer could be indicative of various underlying issues that may affect their overall well-being and performance.
Fatigue in a dancer might result from factors such as inadequate nutrition, overtraining, insufficient rest, or underlying medical conditions. It's important for the nurse to explore further to understand the potential causes of the fatigue and address them appropriately.
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