Nursing Elites

1. . One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acutecare nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following?

• A. Help distinguish hyponatremia from hypernatremia
• B. Help evaluate pituitary gland function
• C. Help distinguish reduced renal blood flow from decreased renal function
• D. Help provide an effective treatment for hypertension-induced oliguria

Correct answer: C

Rationale:

2. What is the main water-holding force in the blood capillaries?

• A. Capillary blood pressure
• B. Sodium in the blood plasma
• C. Protein in the blood plasma
• D. Chloride in the blood plasma

Correct answer: C

Rationale: The correct answer is C: Protein in the blood plasma. Plasma proteins, especially albumin, create oncotic pressure, which is the main force responsible for holding water within the blood capillaries. Capillary blood pressure (Choice A) is involved in pushing blood through the capillaries, while sodium and chloride in the blood plasma (Choices B and D) are electrolytes and do not play a significant role in the water-holding force within capillaries.

3. A 65-year-old male patient was admitted to a medical-surgical unit 72 hours ago with pyloric stenosis; a nasogastric tube was inserted upon admission and has been on low intermittent suction since then. The nurse taking care of the patient notices that his potassium is very low and becomes concerned that the patient may be at risk for:

• A. Hypercalcemia
• B. Metabolic acidosis
• C. Metabolic alkalosis
• D. Respiratory acidosis

Correct answer: C

Rationale: The correct answer is C, metabolic alkalosis. The patient with pyloric stenosis has been on low intermittent suction, leading to the loss of hydrogen and chloride ions. This condition causes metabolic alkalosis due to the removal of these ions. Options A (Hypercalcemia) and D (Respiratory acidosis) are incorrect as they are not directly related to the scenario described. Option B (Metabolic acidosis) is also incorrect; in this case, the patient is at risk of metabolic alkalosis due to the loss of hydrogen and chloride ions through gastric suction.

4. . A nurse assesses a client who had an intraosseous catheter placed in the left leg. Which assessment finding is of greatest concern?

• A. The catheter has been in place for 20 hours.
• B. . The client has poor vascular access in the upper extremities.
• C. The catheter is placed in the proximal tibia.
• D. The clients left lower extremity is cool to the touch.

Correct answer: D

Rationale:

5. A nurse is caring for clients with electrolyte imbalances on a medical-surgical unit. Which clinical manifestations are correctly paired with the contributing electrolyte imbalance? (Select all that do not apply.)

• A. Hypokalemia Flaccid paralysis with respiratory depression
• B. Hyperphosphatemia Paresthesia with sensations of tingling and numbness
• C. . Hyponatremia Decreased level of consciousness
• D.

Correct answer: B

Rationale:

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