Which client has the greatest need for special mouth care?

A 37-year-old who has insulin-dependent diabetes mellitus.

A 58-year-old who wears dentures.

A 26-year-old who is on bed rest.

A 45-year-old who is NPO.

Answer and Explanation

The Correct Answer is A

A 37-year-old who has insulin-dependent diabetes mellitus has the greatest need for special mouth care. This is because diabetes can affect the blood vessels and nerves in the mouth, leading to dry mouth, gum disease, infections, and delayed healing. Special mouth care for this client would include regular brushing and flossing, using a soft toothbrush or foam brush, rinsing with water or saline, checking for signs of inflammation or infection, and avoiding sugary or acidic foods and drinks.

Choice B is wrong because a 58-year-old who wears dentures does not have a greater need for special mouth care than a diabetic client.

Dentures can be removed and cleaned with a soft toothbrush and denture cleaner, and soaked overnight in a denture solution. The gums and mouth should also be cleaned daily with a soft toothbrush or gauze.

Choice C is wrong because a 26-year-old who is on bed rest does not have a greater need for special mouth care than a diabetic client. Bed rest can cause dry mouth and plaque accumulation, but these can be prevented by regular brushing and rinsing, drinking water frequently, and using sugar-free gum or lozenges.

Choice D is wrong because a 45-year-old who is NPO (nothing by mouth) does not have a greater need for special mouth care than a diabetic client. NPO can cause dry mouth and bad breath, but these can be alleviated by regular rinsing with water or saline, applying water-based lip balm or moisturizer, and using artificial saliva products if needed.

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Correct Answer is B

Explanation

To find the rate of the pump in ml/hour, you need to first convert the client’s weight from pounds to kilograms. You can do this by dividing the weight by 2.2046 or multiplying it by 0.454.

For example:

297 lbs / 2.2046 = 134.72 kg or 297 lbs x 0.454 = 134.72 kg

Then, you need to multiply the client’s weight in kilograms by the ordered dose in units/kg/hour to get the total units per hour.

For example:

134.72 kg x 12 units/kg/hour = 1616.64 units/hour

Next, you need to set up a proportion to find the rate of the pump in ml/hour using the supplied medication concentration.

For example:

25,000 units / 500 ml = 1616.64 units / X ml Cross-multiply and solve for X:

25,000 x X = 808320 X = 808320 / 25000 X = 32.33 ml/hour

Finally, you need to round your answer to the nearest tenth of a ml/hour as per the medication administration guidelines.

For example:

32.33 ml/hour ≈ 32.3 ml/hour

Therefore, the rate of the pump is 32.3 ml/hour.

Choice A is wrong because it uses a different conversion factor for pounds to kilograms (1 lb = 0.5 kg) which is not accurate.

Choice C is wrong because it uses a different ordered dose (10 units/kg/hour) which is not what the provider has written.

Choice D is wrong because it uses a different supplied medication concentration (20,000 units in 500 ml) which is not what is available.

A. Has the client had negative interactions with other clients in the past?. B. Does the client have hostile thoughts about others?. C. Is the client fearful of others on the unit?. D. What are the client’s cultural norms?.

Correct Answer is D

Explanation

What are the client’s cultural norms? This question is important because it helps to assess whether the client’s behavior is influenced by their cultural background and values, which may differ from those of the staff and other clients.

For example, some cultures may value privacy, modesty, or respect for elders more than others, and may avoid eye contact or social interaction as a sign of politeness or deference.

Understanding the client’s cultural norms can help to provide culturally sensitive and appropriate care.

Choice A is wrong because it assumes that the client’s behavior is caused by negative interactions with other clients, which may not be the case.

Choice B is wrong because it assumes that the client’s behavior is caused by hostile thoughts about others, which may not be the case.

Choice C is wrong because it assumes that the client’s behavior is caused by fear of others in the unit, which may not be the case.

These choices are not relevant to planning the client’s care and may reflect bias or stereotyping on the part of the staff.

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Which client has the greatest need for special mouth care?

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Naxlex Comprehensive Predictor Exams

A provider has written an order for a medication drip to be started at 12 units/kg/hour. Your client weighs 297 Ibs. The medication is supplied as 25,000 units in 500 ml. At what rate would you set your pump?

Correct Answer is B

Explanation

A client makes minimal eye contact with others and remains alone in their room during the day. Which question is an important consideration when planning the client’s care?

Correct Answer is D

Explanation

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