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Questions 164

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Extract:

Intake and output record

Emesis 120 mL
Wet diaper 1 50 g
Wet diaper 2 52 g
Wet diaper 3 46 g

*Weight of a dry diaper = 30 g
Intake and output record


Question 1 of 5

The nurse is calculating a client's intake and output for the shift. How many mL should the nurse record as the client's output?

Correct Answer: 208

Rationale: Emesis (120 mL) plus diaper output (50-30=20 mL, 52-30=22 mL, 46-30=16 mL) totals 120+20+22+16=208 mL.

Extract:


Question 2 of 5

The nurse is reinforcing teaching to a client diagnosed with Raynaud phenomenon about ways to prevent recurrent episodes. Which instructions should the nurse include? Select all that apply.

Correct Answer: A,C,D,E

Rationale: Caffeine, tobacco, and cold exposure can trigger Raynaud episodes. Yoga/tai chi and gloves help prevent attacks. Cold water immersion exacerbates symptoms.

Question 3 of 5

The daughter of an 80-year-old client recently diagnosed with Alzheimer disease (AD) says to the nurse, 'I guess I can anticipate getting this disease myself at some point.' What is an appropriate response by the nurse?

Correct Answer: A

Rationale: Regular exercise is associated with a reduced risk of Alzheimer disease. Family history is a risk factor, and aluminum is not a proven cause.

Question 4 of 5

The nurse is reinforcing teaching for a client recently diagnosed with heart failure who is being discharged with a prescription for lisinopril. Which of the following information should the nurse include?

Correct Answer: D

Rationale: Lisinopril can cause orthostatic hypotension, so slow position changes prevent dizziness and falls.

Question 5 of 5

The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal?

Correct Answer: D

Rationale: Ativan (lorazepam), a benzodiazepine, is used to manage alcohol withdrawal symptoms like seizures and agitation. Antabuse deters drinking, flumazenil reverses benzodiazepines, and methadone treats opioid withdrawal.

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