A client weighing 120 pounds has received burns over 40% of his body at 1200 hours. Using the Parkland formula, calculate the expected amount of fluid that the client should receive by 2000 hours as fluid-replacement therapy?
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Solution
Answer B is correct. The nurse must know military times, the Parkland formula, and how to calculate the amount of fluid. The Parkland formula is 4mL × weight in kilograms × percentage of body surface area burned = the amount to be given in 24 hours. The nurse is to give half this amount in the first 8 hours.
4mL × 54kg × 40 BSA = 8640mL (amount to be given in 24 hours). Give half this amount in the first 8 hours:
8640 ÷ 2 = 4320
Answers A, C, and D are incorrect calculations.
A client has received damage to the parietal lobe. Which symptom would be expected due to this tumor’s location?
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Solution
Answer C is correct. The parietal lobe deals with sensation. Therefore, anyone with a problem in this area of the brain can have problems with sensation. Answers A, B, and D are not directly associated with this part of the brain.
A client is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a side effect of this drug?
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Solution
Answer C is correct. Tegretol can cause bone marrow depression, which is evident by the low WBC of 4,000 (normal 5,000–10,000). It can also cause problems with the liver that would raise the BUN (normal 5–25mg/dL). Answers A, B, and D are not related to the adverse effects of this drug.
A client is admitted with possible paralytic illeus. Which question during the nursing history is least helpful in obtaining information regarding this diagnosis?
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Solution
Answer C is correct. Asking the client about his usual diet is the least helpful information in identifying the problem. Answer A would be important because the pain sometimes decreases as obstruction worsens. The distention in answer D indicates obstruction. Answer B is common because the vomiting can help differentiate the type of obstruction.
The nurse is reinforcing teaching of a client with diverticulitis about appropriate foods. Which food would be avoided?
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Solution
Answer C is correct. A client with diverticulitis should avoid high-fiber foods containing seeds or nuts. Other foods to avoid include corn, popcorn, celery, figs, and strawberries. Answers A, B, and D are foods that do not contain nuts or seeds and would not need to be avoided.
The nurse is explaining a low-residue diet to a client with ulcerative colitis. Which food would need to be eliminated from this client’s diet?
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Solution
Answer C is correct. Raw or cooked vegetables are not allowed on a low-residue diet. Answers A, B, and D are all allowed foods.
When planning the care for a client after a posterior fossa (infratentorial) craniotomy, which would be contraindicated?
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Solution
Answer B is correct. Any posterior craniotomy requires the client to lie flat rather than with the head of the bed elevated, as in answer B. A posterior fossa procedure would be at the lower back of the head. Therefore, answer C would not be contraindicated and answer D would help to decrease intracranial pressure.
A pneumonectomy is performed on a client with lung cancer. Which of the following would not be an expected prescription?
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Solution
Answer A is correct. Closed chest drainage is not usually used because it is helpful for serous fluid to accumulate in the space to prevent mediastinal shift. Answers B, C, and D are all parts of the care on a client with lung surgery
A client diagnosed with emphysema is going to the clinic for assistance with smoking cessation. Which drug would the nurse expect to be included in the treatment plan?
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Solution
Answer A is correct. Zyban and Wellbutrin are classified as antidepressants and have been proven to increase long-term smoking abstinence. Answers B and C are bronchodilator drugs and are not used for smoking cessation. Answer D is a short-acting benzodiazepine that is not used for smoking cessation therapy
A client is receiving Theodur. The nurse monitors the theophylline blood level and assesses that the level is within therapeutic range when it is at what level?
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Solution
Answer C is correct. A level of 15ug/mL is within the normal theophylline therapeutic range of 10-20ug/mL. Answers A, B, and D are not within the therapeutic range.